Abstract: SA-PO052
Diffusion-Weighted Magnetic Resonance Imaging (DWI) Correlates with Renal Injury in Patients with Renovascular Disease (RVD)
Session Information
- Engineering-Based Approaches to Problems in Nephrology
November 09, 2019 | Location: Exhibit Hall, Walter E. Washington Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Bioengineering
- 300 Bioengineering
Authors
- Ferguson, Christopher M., Mayo Clinic, Rochester, Minnesota, United States
- Eirin, Alfonso, Mayo Clinic, Rochester, Minnesota, United States
- Abumoawad, Abdelrhman, Mayo Clinic, Rochester, Minnesota, United States
- Jiang, Kai, Mayo Clinic, Rochester, Minnesota, United States
- Hedayat, Ahmad Fahim, University of Mississipi Medical Center, Ridgeland, Mississippi, United States
- Lerman, Amir, Mayo Clinic, Rochester, Minnesota, United States
- Textor, Stephen C., Mayo Clinic, Rochester, Minnesota, United States
- Lerman, Lilach O., Mayo Clinic College of Medicine, Rochester, Minnesota, United States
Background
There is pressing need to identify novel markers that can predict response to therapy in patients with RVD. DWI is a useful tool for the assessment of renal microstructure and DWI-derived apparent diffusion coefficient (ADC) reflects unobstructed water diffusion. We hypothesized that lower values of ADC (index of fibrosis) can be used as an index of renal injury and response to therapy.
Methods
ADC and renal hypoxia (R2*; blood oxygen level dependent-MRI) were studied before and 3 months after treatment in 20 patients (23 stenotic kidneys) with hemodynamically significant RVD under constant sodium intake. Patients were treated with medical therapy (n=9) or medical therapy plus renal revascularization (n=11, n=14 kidneys). Serum creatinine (Scr), eGFR (CKD-EPI), blood pressure (BP), and systemic levels of pro-inflammatory marker tumor necrosis factor (TNF)-α, were measured at each time-point. Baseline ADC values were correlated with change in renal hypoxia and systolic BP (SBP), as well as TNF-α levels at 3 months.
Results
BP and Scr decreased and eGFR increased 3 months after therapy (Table), but renal hypoxia and TNF-α levels remained unchanged. Overall, ADC values increased 3 months after therapy (Fig. A), although not in medical therapy or renal revascularization considered separately. Baseline ADC values modestly and inversely correlated with changes in hypoxia and SBP, and with TNF-α levels at 3 months (Fig. B), but not with levels of or changes in renal function.
Conclusion
Lower levels of ADC may potentially reflect kidney injury, but do not predict changes in renal function after therapy over 3 months in patients with RVD. Future studies need to identify indices of renal recovery potential.
Funding
- NIDDK Support