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A Large Animal Model for Acute Kidney Injury by Temporary Bilateral Renal Artery Occlusion
Published on: February 2, 2021
Assessment of Acute Kidney Injury using MRI
Nicholas M Selby1,2, Susan T Francis3,4
1Centre for Kidney Research and Innovation, Academic Unit for Translational Medical Sciences, School of Medicine, University of Nottingham, Nottingham, UK.
Abstract:
There has been growing interest in using quantitative magnetic resonance imaging (MRI) to describe and understand the pathophysiology of acute kidney injury (AKI). The ability to assess kidney blood flow, perfusion, oxygenation, and changes in tissue microstructure at repeated timepoints is hugely appealing, as this offers new possibilities to describe nature and severity of AKI, track the time-course to recovery or progression to chronic kidney disease (CKD), and may ultimately provide a method to noninvasively assess response to new therapies. This could have significant clinical implications considering that AKI is common (affecting more than 13 million people globally every year), harmful (associated with short and long-term morbidity and mortality), and currently lacks specific treatments. However, this is also a challenging area to study. After the kidney has been affected by an initial insult that leads to AKI, complex coexisting processes ensue, which may recover or can progress to CKD. There are various preclinical models of AKI (from which most of our current understanding derives), and these differ from each other but more importantly from clinical AKI. These aspects are fundamental to interpreting the results of the different AKI studies in which renal MRI has been used, which encompass different settings of AKI and a variety of MRI measures acquired at different timepoints. This review aims to provide a comprehensive description and interpretation of current studies (both preclinical and clinical) in which MRI has been used to assess AKI, and discuss future directions in the field. LEVEL OF EVIDENCE: 1 TECHNICAL EFFICACY: Stage 3.
Insights
Quantitative magnetic resonance imaging (MRI) offers promising ways to study acute kidney injury (AKI). This technique can assess kidney function and microstructure, aiding in understanding AKI progression and treatment response.
Area of Science:
- Nephrology
- Radiology
- Biomedical Engineering
Background:
- Acute kidney injury (AKI) affects millions globally, carrying significant morbidity and mortality.
- Current treatments for AKI are limited, highlighting the need for better understanding and monitoring.
- Quantitative MRI presents a non-invasive approach to assess kidney pathophysiology.
Purpose of the Study:
- To review and interpret current preclinical and clinical studies using MRI for AKI assessment.
- To discuss the potential of MRI in understanding AKI severity, progression, and treatment response.
- To explore future directions for renal MRI in AKI research.
Main Methods:
- Comprehensive literature review of preclinical and clinical studies utilizing quantitative MRI in AKI.
- Analysis of various MRI techniques assessing kidney blood flow, perfusion, oxygenation, and microstructure.
- Interpretation of findings across different AKI models and clinical settings.
Main Results:
- Quantitative MRI enables detailed assessment of kidney function and tissue changes in AKI.
- MRI can track AKI progression, recovery, and potential transition to chronic kidney disease (CKD).
- The technique holds potential for non-invasive evaluation of therapeutic interventions in AKI.
Conclusions:
- Quantitative MRI is a valuable tool for understanding AKI pathophysiology and clinical course.
- Further research is needed to standardize MRI protocols and validate findings across diverse AKI contexts.
- Renal MRI shows significant promise for improving AKI management and therapeutic development.
