Abstract: FR-PO214

Diffusion-Weighted Magnetic Resonance Imaging (DWI) Correlates with the Response to Renal Revascularization in Patients with Atherosclerotic Renovascular Disease (ARVD)

Session Information

Category: Hypertension

  • 1104 Hypertension: Clinical and Translational - Salt and Hypertension

Authors

  • Hedayat, Ahmad Fahim, Mayo Clinic, Rochester, Minnesota, United States
  • Eirin, Alfonso, Mayo Clinic, Rochester, Minnesota, United States
  • Ferguson, Christopher M., Mayo Clinic, Rochester, Minnesota, United States
  • Glockner, James, Mayo Clinic, Rochester, Minnesota, United States
  • Textor, Stephen C., Mayo Clinic, Rochester, Minnesota, United States
  • Lerman, Lilach O., Mayo Clinic, Rochester, Minnesota, United States
Background

Selecting patients with ARVD likely to improve glomerular filtration rate (GFR) after percutaneous transluminal renal angioplasty (PTRA) is challenging. DWI is an experimental tool to assess tissue morphology based on water molecule motion, and its index apparent diffusion coefficient (ADC) falls in damaged kidneys. We hypothesized that low basal ADC values would identify stenotic kidneys with subsequent diminished functional recovery after PTRA.

Methods

ADC was measured on 3T MRI in 20 patients with hemodynamically significant ARVD before and 3 months after standardized medical therapy (renin-angiotensin system inhibition) with or without PTRA. During protocol studies patients consumed a constant sodium intake, and eGFR was measured by CKD-EPI. Baseline ADC values were correlated with the change in eGFR after PTRA (delta eGFR).

Results

Baseline eGFR and ADC values were similar between groups (p>0.05). ADC values increased In patients 3 months after PTRA, and correlated directly with delta GFR, but remained unchanged in patients treated with medical therapy (MT) alone.

Conclusion

Low basal ADC value may serve as biomarker of kidney injury and predict benefit from revascularization in ARVD. This noninvasive imaging technique may be useful for identification of patients likely to improve renal function after revascularization.

Funding

  • NIDDK Support