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Abstract: TH-PO869

The Associations of Kidney Functional Magnetic Resonance Imaging Biomarkers of Oxygenation and Fibrosis With Inflammatory Biomarkers in Individuals With Advanced CKD

Session Information

Category: CKD (Non-Dialysis)

  • 2201 CKD (Non-Dialysis): Epidemiology‚ Risk Factors‚ and Prevention

Authors

  • Trujillo, Jacquelyn, Northwestern University Feinberg School of Medicine, Chicago, Illinois, United States
  • Alotaibi, Manal, Northwestern University Feinberg School of Medicine, Chicago, Illinois, United States
  • Seif, Nay, Northwestern University Feinberg School of Medicine, Chicago, Illinois, United States
  • Cai, Xuan, Northwestern University Feinberg School of Medicine, Chicago, Illinois, United States
  • Larive, Brett, Cleveland Clinic, Cleveland, Ohio, United States
  • Gassman, Jennifer J., Cleveland Clinic, Cleveland, Ohio, United States
  • Raphael, Kalani L., Oregon Health & Science University, Portland, Oregon, United States
  • Raj, Dominic S., The George Washington University School of Medicine and Health Sciences, Washington, District of Columbia, United States
  • Fried, Linda F., University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, United States
  • Sprague, Stuart Michael, NorthShore University HealthSystem, Evanston, Illinois, United States
  • Block, Geoffrey A., US Renal Care, Dallas, Texas, United States
  • Chonchol, Michel, University of Colorado Denver School of Medicine, Aurora, Colorado, United States
  • Middleton, John Paul, Duke University School of Medicine, Durham, North Carolina, United States
  • Wolf, Myles, Duke University School of Medicine, Durham, North Carolina, United States
  • Ix, Joachim H., University of California San Diego School of Medicine, La Jolla, California, United States
  • Prasad, Pottumarthi V., NorthShore University HealthSystem, Evanston, Illinois, United States
  • Isakova, Tamara, Northwestern University Feinberg School of Medicine, Chicago, Illinois, United States
  • Srivastava, Anand, Northwestern University Feinberg School of Medicine, Chicago, Illinois, United States
Background

Chronic kidney hypoxia and tubulointerstitial fibrosis promote chronic inflammation, which may lead to worsening CKD progression. There is limited data on the associations between non-invasive markers of kidney oxygenation and fibrosis with inflammation.

Methods

We evaluated the association of baseline kidney functional magnetic resonance imaging (fMRI) biomarkers of oxygenation and fibrosis with interleukin-6 (IL-6) and C-reactive protein (CRP) in 127 participants from the COMBINE trial, which was a randomized, 12-month study of nicotinamide and lanthanum carbonate vs. placebo in individuals with CKD stages 3-4. Higher cortical relaxation rate (R2*) on BOLD MRI may represent decreased oxygenation. Lower cortical apparent diffusion coefficient (ADC) on diffusion-weighted MRI may indicate greater fibrosis. Multivariable linear regression models tested the associations between kidney fMRI and inflammatory biomarkers at baseline. Linear mixed effects models tested the association of baseline kidney fMRI biomarkers with change in inflammatory biomarkers over time.

Results

At baseline, mean±SD eGFR, R2*, and ADC was 32.2±8.7 ml/min/1.73m2, 20.3±3.1 s-1, 1.46±0.17 mm3/s, respectively. Median [IQR] IL-6 and CRP was 3.7 [2.4–4.9] pg/mL and 2.8 [1.2–6.3] mg/L. At baseline, cortical R2* did not have a significant association with IL-6 or CRP, but higher ADC was associated with lower IL-6 and CRP (Figure 1A). Mean annual IL-6 and CRP slope were 0.98 (95% CI 0.85–1.12) pg/mL per year and 0.91 (95% CI 0.79–1.06) mg/L per year, respectively. Cortical ADC and R2* did not have significant associations with change in IL-6 or CRP over time (Figure 1B).

Conclusion

In individuals with advanced CKD, higher cortical ADC, suggestive of less cortical fibrosis, was associated with lower inflammation, as assessed by IL-6 and CRP. Kidney fMRI biomarkers did not associate with change in inflammatory biomarkers over time.

Funding

  • NIDDK Support