Evaluation of Renal Blood Flow in Chronic Kidney Disease Using Arterial Spin Labeling Perfusion Magnetic Resonance Imaging
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Published on: May 30, 2011
Lu-Ping Li1, Huan Tan1, Jon M Thacker2
1Center for Advanced Imaging, NorthShore University HealthSystem, Evanston, IL.
Insights
Arterial Spin Labeling MRI revealed significantly reduced renal blood flow in patients with moderate Chronic Kidney Disease (CKD). This non-invasive technique shows promise for evaluating renal blood flow in CKD patients.
Area of Science:
- Nephrology
- Radiology
- Medical Imaging
Background:
- Chronic kidney disease (CKD) is linked to diminished renal blood flow, but human data is scarce.
- Understanding renal hemodynamics in CKD is crucial for disease management.
Purpose of the Study:
- To assess renal blood flow using non-invasive Arterial Spin Labeling (ASL) MRI in patients with stage-3 CKD.
- To compare renal blood flow between CKD patients and healthy controls.
Main Methods:
- ASL MRI was performed on 33 patients with diabetes and stage-3 CKD and 30 healthy controls.
- Renal cortical and medullary blood flow were quantified.
- Correlations with estimated Glomerular Filtration Rate (eGFR), age, and BMI were analyzed.
Main Results:
- CKD patients exhibited significantly lower cortical and medullary renal blood flow compared to controls (p<0.001).
- Both cortical and medullary blood flow correlated with eGFR.
- Even after matching for age and BMI, significant differences in renal blood flow persisted between groups.
Conclusions:
- ASL MRI is a valuable tool for evaluating renal blood flow in moderate CKD.
- Further longitudinal studies are needed to determine if ASL can predict CKD progression.
Introduction:
Chronic kidney disease (CKD) is known to be associated with reduced renal blood flow. However, data to-date in humans is limited.
Methods:
In this study, non-invasive arterial spin labeling (ASL) MRI data was acquired in 33 patients with diabetes and stage-3 CKD, and 30 healthy controls.
Results:
A significantly lower renal blood flow both in cortex (108.4±36.4 vs. 207.3±41.8; p<0.001, d=2.52) and medulla (23.2±8.9 vs. 42.6±15.8; p<0.001, d=1.5) was observed. Both cortical (ρ=0.67, p<0.001) and medullary (ρ=0.62, p<0.001) blood flow were correlated with eGFR, and cortical blood flow was found to be confounded by age and BMI. However, in a subset of subjects that were matched for age and BMI (n=6), the differences between CKD and control subjects remained significant both in cortex (107.4±42.8 vs. 187.51±20.44; p=0.002) and medulla (15.43±8.43 vs. 39.18±11.13; p=0.002). A threshold value to separate healthy and CKD was estimated to be Cor_BF=142.9 and Med_BF=24.1.
Conclusion:
These results support the use of ASL in the evaluation of renal blood flow in patients with moderate level of CKD. Whether these measurements can identify subjects at risk of progressive CKD requires further longitudinal follow-up.
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