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Abstract: FR-PO162

Renal Prognosis Evaluation with Contrast-Enhanced Ultrasound

Session Information

Category: CKD (Non-Dialysis)

  • 1901 CKD (Non-Dialysis): Epidemiology, Risk Factors, and Prevention

Authors

  • Xu, Yao, Ren Ji Hospital, school of Medicine, Shanghai Jiao Tong University Shanghai, PR China, Shanghai, China
  • Mou, Shan, Renji Hospital, Shanghai, China
Background

The purpose of this initial study was to confirm the ability of contrast-enhanced ultrasound (CEUS) to detect and predict renal function changes in chronic kidney disease (CKD) patients. The prognostic efficacy of CEUS parameters was compared with that of the renal pathology.

Methods

Patients with biopsy-proved CKD and received CEUS were enrolled in this study. CEUS was performed after an intravenous bolus injection of 1.5 ml SonoVue (BR1; Bracco Milan, Italy). Time-intensity curves (TICs) and quantitative indexes were created using QLAB quantification software. All biopsies were analyzed with α-SMA immunohistochemistry. The Cox proportional hazards model retrospectively investigated risk factors on kidney survival.

Results

A total of 140 patients were followed for a median period of 22.0 months. In total, 18 (13%) patients exhibited CKD progression. Lower derived peak intensity (DPI)and higher resistance index (RI) was noted in CKD progression group. Multivariate Cox regression analysis revealed that the DPI associated with progression of kidney disease. Based on which, linear predictor score (LP) was made. Kaplan-Meier curve showed that DPI had the similar ability as fibrosis to estimate the risk of kidney progression for each CKD patient. Patients with a LP-DPI≥0 were less likely to recover from CKD progression. The area under the receiver operating characteristic (ROC) curves for the model of DPI was 0.82 (95%CI, 0.60-0.96, P<0.001) with a sensitivity of 82% and a specificity of 78%.

Conclusion

This study demonstrated that the DPI might be the most valuable CEUS parameter for the evaluation of renal function deterioration risk. The DPI could serve as an independent predictor of the long-term prognosis of CKD patients.

Kaplan-Meier plots showing renal survival stratified by linear predictor score (LP) from the multivariate Cox proportional hazards model included DPI and α-SMA.