MR Findings of Renal Cortical Necrosis

Jeong, Jin-Yeon; Kim, Seung Hyup; Sim, Jung Suk; Lee, Hak Jong; Do, Kyung-Hyun; Moon, Min Hoan; Lee, Dong Kyung; Seong, Chang Kyu

doi:10.1097/00004728-200203000-00012

Cited by 23 publications

(15 citation statements)

References 5 publications

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“…7b shows, signal intensity on T 2 WI in the cortex in the GM group tended to be higher on Day 7 than Day 0, though not statistically diŠerent. In light of Jeong'sˆndings, 22 our results (Fig. 7b) may suggest that GM-induced nephrotoxicity produced some necroses in the cortex on Day 7, which is also conˆrmed by the histopathological data shown in Fig.…”

Section: Pº0supporting

confidence: 83%

“…22 As Fig. 7b shows, signal intensity on T 2 WI in the cortex in the GM group tended to be higher on Day 7 than Day 0, though not statistically diŠerent.…”

Section: Pº0mentioning

confidence: 70%

“…As previously described, the change of R 2 * re‰ects tissue oxygen consumption, 15 whereas the increase in signal intensity of T 2 WI in the cortex re‰ects some cortical necrosis. 22 Theseˆndings suggest the potential use of BOLD MRI combined with T 2 WI for evaluating both functional and morphological changes in the kidney caused by GM-induced nephrotoxicity. However, further studies are needed to establish the usefulness of this method in clinical settings.…”

Section: Pº0mentioning

confidence: 95%

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Protective Effect of Hydrogen-rich Water against Gentamicin-induced Nephrotoxicity in Rats using Blood Oxygenation Level-dependent MR Imaging

Matsushita

Kusakabe

Kitamura

et al. 2011

MRMS

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Purpose: We assessed intrarenal oxygenation in gentamicin-induced nephrotoxicity (GIN) and the protective eŠect of hydrogen-rich water (HW) against GIN using blood oxygenation level-dependent magnetic resonance (MR) imaging.Materials and Methods: We acquired T 2 * -weighted images (T 2 * WI) of 21 rats on Days 0, 2, 4, and 7 using a 1.5-tesla MR imaging system. The rats were divided into 3 groups of seven each: control rats had free access to standard water and no gentamicin (GM) injection; rats designated the GM group had free access to standard water and were injected with GM (80 mg/kg/day) subcutaneously for 7 days; and the third group, designated the GM＋HW group, had free access to HW and were injected with GM. R 2 * (＝1/T 2 *) was estimated from T 2 *WI.Results: R 2 * values in the cortex were signiˆcantly decreased on Days 2, 4, and 7 compared with those on Day 0 in the GM group but not signiˆcantly changed in the control and GM＋HW groups. R 2 * values in the medulla did not change signiˆcantly in any group.Conclusions: Ourˆndings suggested reduced oxygen utility, mainly in the cortex, in gentamicin-induced nephrotoxicity and an ameliorative eŠect of hydrogen-rich water against GIN.

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Section: Pº0supporting

confidence: 83%

“…22 As Fig. 7b shows, signal intensity on T 2 WI in the cortex in the GM group tended to be higher on Day 7 than Day 0, though not statistically diŠerent.…”

Section: Pº0mentioning

confidence: 70%

Section: Pº0mentioning

confidence: 95%

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Protective Effect of Hydrogen-rich Water against Gentamicin-induced Nephrotoxicity in Rats using Blood Oxygenation Level-dependent MR Imaging

Matsushita

Kusakabe

Kitamura

et al. 2011

MRMS

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“…Early Doppler sonography findings were normal and abdominal MRI without contrast-enhanced material did not support renal cortical necrosis. There is considerable evidence that MRI is useful, non-invasive, and specific in the diagnosis of renal cortical necrosis early in the disease [6].…”

Section: Discussionmentioning

confidence: 99%

Fulminant meningococcemia and acute renal failure in a 3-year-old boy

Akil

Yüksel

Coşkun

et al. 2004

Pediatric Nephrology

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Acute renal failure is a common occurrence in sepsis, but is rarely reported in meningococcemia. We present a young child diagnosed with fulminant meningococcemia who had several poor prognostic factors, including hypotension, thrombocytopenia, purpura fulminans, seizures, the absence of meningitis with meningococcemia, and acute renal failure, which was successfully treated with peritoneal dialysis. Peritoneal dialysis was started on the 5th day because the patient had been anuric for 48 h. At that time, analysis showed that the child was both hypokalemic and hypophosphatemic. His serum blood urea nitrogen was 61 mg/dl, creatinine 2.75 mg/dl, potassium 2.8 mEq/l, and phosphorus 0.7 mg/dl. Urine output began on the 12th day post admission and normalization of serum creatinine was achieved on the 26th day. In conclusion, renal failure is an important complication of meningococcemia and, to be effective, sometimes long-term peritoneal dialysis is required. Profound metabolic abnormalities, such as hypokalemia and hypophosphatemia, may occur paradoxically in the presence of oliguria.

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“…Abruptio placenta is the most common obstetric cause of RCN accounting for 50-60% of cases in developed countries. 14,26 Although obstetrical complications are the commonest causes of RCN in all the published series, 1-8 the spectrum of these complications causing RCN differ between developed and developing countries; with placental abruption and concealed hemorrhage being common in the former and sepsis(postabortal and puerperal sepsis) in the latter. 1,2,5,12 RCN is very rare following septic abortion in developed countries but a common cause of obstetric RCN in India.…”

Section: Discussionmentioning

confidence: 99%

Renal cortical necrosis is a disappearing entity in obstetric acute kidney injury in developing countries: our three decade of experience from India

et al. 2015

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Rational: Obstetrical complications are the commonest causes of Renal Cortical Necrosis (RCN). However, the overall incidence of RCN in obstetric acute kidney injury in developing countries has been decreasing in recent years. Objective: The aim of this study was to evaluate the changing profile of RCN in obstetric AKI over the last three decades. Methods: This single center study included patients with biopsy proven renal cortical necrosis over a period of 32 years from 1982 to 2014. The diagnosis of RCN was suspected in patients with prolonged AKI (44 weeks) with absolute anuria in the setting of hemorrhage, hypotension and sepsis; and was confirmed by renal biopsy. The changing pattern in the incidence, etiology and outcome of RCN in patients with obstetric AKI was compared in the three study periods, namely 1982-1991, 1992-2002 and 2003-2014. Results: Over a period of 32 years, RCN was diagnosed in 15/259(5.8%) cases of obstetric AKI. Diffuse and patchy cortical necrosis were noted in 8(53.3%) and 7(46.7%) patients, respectively. RCN occurred in 17%(11/65), 2.4%(3/125) and 1.44%(1/69) patients in 1982-1991, 1992-2002 and 2003-2014, respectively. Septic abortion was commonest cause of RCN in the first two study periods but no case was observed in last decade. The decrease in incidence of RCN over the three decades was statistically significant (p-value50.001). Maternal mortality decreased to zero in 2003-2014 from 72.7% in 1982-1991. Conclusions: The incidence of RCN in obstetric AKI in developing countries has declined low enough to label it as a disappearing entity.

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MR Findings of Renal Cortical Necrosis

Abstract: MRI, especially T2-weighted and contrast-enhanced T1-weighted imaging, was helpful in evaluating renal cortical necrosis.

Cited by 23 publications

References 5 publications

Protective Effect of Hydrogen-rich Water against Gentamicin-induced Nephrotoxicity in Rats using Blood Oxygenation Level-dependent MR Imaging

Protective Effect of Hydrogen-rich Water against Gentamicin-induced Nephrotoxicity in Rats using Blood Oxygenation Level-dependent MR Imaging

Fulminant meningococcemia and acute renal failure in a 3-year-old boy

Renal cortical necrosis is a disappearing entity in obstetric acute kidney injury in developing countries: our three decade of experience from India

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