Multisystem Imaging Manifestations of Kidney Failure

Area of Science:

• Nephrology
• Radiology
• Pathology

Background:

• Kidney failure (KF) involves declining glomerular filtration rate, leading to complex multisystemic complications.
• Hemodynamic, metabolic, inflammatory, and coagulopathic changes in KF contribute to these complications.
• Secondary hyperparathyroidism is an imaging hallmark, causing bone resorption and other musculoskeletal issues.

Purpose of the Study:

• To review the extrarenal systemic manifestations of kidney failure.
• To discuss the appropriate imaging modalities for assessing these complications.
• To detail the imaging findings associated with various KF complications.

Main Methods:

• Review of literature on systemic manifestations of kidney failure.
• Analysis of imaging techniques (radiography, CT, MRI) for assessing complications.
• Discussion of contrast agent safety in patients with kidney failure.

Main Results:

• Common complications include musculoskeletal (bone resorption, brown tumor), cardiovascular (atherosclerosis, cardiomyopathy), neurologic (encephalopathy), and pulmonary (edema).
• Radiography and CT are used for musculoskeletal and thoracic issues; MRI is key for neurologic and cardiovascular assessments.
• Iodinated CT contrast is generally avoided in KF, while Group II gadolinium MRI contrast is considered safe.

Conclusions:

• Kidney failure leads to diverse systemic complications requiring specific imaging approaches.
• Careful selection of imaging modality and contrast agents is crucial for patient safety.
• Understanding imaging findings aids in diagnosing and managing complications in kidney failure patients.