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Kidney Week

Abstract: FR-PO426

Functional Magnetic Resonance Imaging (MRI) Is Promising in Predicting the Prognosis of Diabetic Kidney Disease (DKD): Confirmed by the Cohort Study

Session Information

Category: Diabetic Kidney Disease

  • 602 Diabetic Kidney Disease: Clinical

Authors

  • Li, Jing, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
  • Wang, Huizhen, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
  • Xie, Jianteng, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
  • Liang, Tiantian, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
  • Zhang, Yifan, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
  • Wang, Yanhui, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
  • Wang, Wenjian, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
Background

DKD, the major cause of CKD and ESRD globally, which prognosis is determined by tissue hypoxia or fibrosis. However, assess the two aspects noninvasively is difficult. Whether functional MRI is available for predicting outcomings has not been proven.

Methods

we performed a corhort study in 67 DKD patients, measuring their renal oxygenation by blood oxygenation level-dependent(BOLD) MRI and fibrosis by intravoxel incoherent motion (IVIM) diffusion weighted imaging (DWI). 10 diabetes mellitus were recruited as control. The correlation were caculated by pearson linear analysis. Student's t-test and one-way ANOVA were used to assess the difference among groups. the area under the curve (AUC) were built to assess the discriminative accuracy of MRI values with GFR. finally, Kaplan-Meier analysis was used to evaluate the prognosis after follow up.

Results

Differences were discovered in MRI values between DKD groups and controls. There is strong positive corelation between cortex ADC (p<0.0001)or D value (p<0.0001)and GFR, but negative correlation found in cortex R2*( p=0.0008). AUC (identify with eGFR) of cortex D, was 0.86 (95% CI 0.79–0.93) stronger than the AUC of the cortex ADC (AUC: 0.84, 95% CI 0.77–0.92) or cortex R2* (AUC: 0.67, 95% CI: 0.57–0.77). A further increase in the AUC was obtained taking ECT-GFR as a standard. Follow-up period was 22.4±12.7 months, Kaplan-Meier curve according to cortex D over time showed a significantly different prognosis(Log-rank=23.26; P<0.0001), in contrast , that cortex R2* value is less accurate(Log-rank=16.7; p=0.001).

Conclusion

Cortex D value is in good agreement with the decline of renal function, Thus, cortex D value is an ideal biomarker for predicting the prognosis, cortex R2* is less accurate than cortex D but also helpful in judging prognosis.

Pseudo-color maps and analysed results