Abstract: TH-PO352

Contrast-Enhanced Ultrasound for Assessing Renal Perfusion Impairment and Predicting AKI to CKD Progression

Session Information

Category: Acute Kidney Injury

  • 001 AKI: Basic

Author

  • Cao, Wei, Division of Nephrology, Nanfang Hospital, Southern Medical University, Guangzhou, China
Background

Acute kidney injury (AKI) is increasing recognized as a major risk factor leading to progression to chronic kidney disease (CKD). However, the diagnostic tools for predicting AKI to CKD progression are particularly lacking. Here, we tested the utility of contrast enhanced ultrasound (CEUS) for predicting progression to CKD after AKI.

Methods

Mice treated with 20 or 45 min ischemia-reperfusion injury (IRI) was served as mild or severe AKI. Renal perfusion was evaluated by CEUS. Kidney morphological injury and function were assessed. We further measured renal perfusion by CEUS in patients who admitted for acute decompensated heart failure (ADHF) with or without AKI-CKD progression.

Results

Renal perfusion measured by CEUS reduced to 25%±7% and 14%±6% of the pre-ischemic levels in mild and severe AKI 1 hour after ischemia (P<0.05). Renal perfusion returned to pre-ischemic levels 1 day after mild AKI followed by restoration of kidney function. While severe AKI caused persisted renal perfusion impairment (60%±9% of baseline levels) accompanied by progressive renal fibrosis and sustained decrease in renal function. Renal perfusion at day 1-21 significantly correlated with tubulointerstitial fibrosis 42 days after AKI. For predicting renal fibrosis at day 42, the area under receiver operating characteristics curve of renal perfusion impairment at day 1 was 0.84. Similar changes in renal image of CEUS were observed in patients with AKI-CKD progression. By using microbubbles targeted to P-Selectin, CEUS was able to quantify the severity of renal microvascular injury after AKI.

Conclusion

These results indicate that CEUS enables the evaluation of renal perfusion impairment associated with CKD after ischemic AKI and may serve as a noninvasive technique for assessing AKI-CKD progression.

Funding

  • Government Support - Non-U.S.