Assessment of Renal Fibrosis in Patients With Chronic Kidney Disease Using Shear Wave Elastography and Clinical Features: A Random Forest Approach

Chen, Ziman; Ying, Tin Cheung; Chen, Jiaxin; Wang, Yingli; Wu, Chaoqun; Su, Zhongzhen

doi:10.1016/j.ultrasmedbio.2023.03.024

Cited by 3 publications

(1 citation statement)

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“…The pathogenesis of renal fibrosis is intricate, encompassing the activation of numerous proteins [ 21 ]. α-SMA, a crucial cytoskeletal protein in the renal fibrosis process, is mainly expressed in renal interstitial fibroblasts [ 22 ].…”

Section: Discussionmentioning

confidence: 99%

Kangxianling formula attenuates renal fibrosis by regulating gut microbiota

Tao,

Liu,

Hou

et al. 2024

Eur J Med Res

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Background Renal fibrosis (RF) produced adverse effect on kidney function. Recently, intestinal dysbiosis is a key regulator that promotes the formation of renal fibrosis. This study will focus on exploring the protective mechanism of Kangxianling Formula (KXL) on renal fibrosis from the perspective of intestinal flora. Methods Unilateral Ureteral Obstruction (UUO) was used to construct rats’ model with RF, and receive KXL formula intervention for 1 week. The renal function indicators were measured. Hematoxylin–eosin (HE), Masson and Sirus red staining were employed to detect the pathological changes of renal tissue in each group. The expression of α-SMA, Col-III, TGF-β, FN, ZO-1, and Occuludin was detected by immunofluorescence and immunohistochemistry. Rat feces samples were collected and analyzed for species’ diversity using high-throughput sequencing 16S rRNA. Results Rats in UUO groups displayed poor renal function as well as severe RF. The pro-fibrotic protein expression in renal tissues including α-SMA, Col-III, TGF-β and FN was increased in UUO rats, while ZO-1 and Occuludin -1 expression was downregulated in colon tissues. The above changes were attenuated by KXL treatment. 16S rRNA sequencing results revealed that compared with the sham group, the increased abundance of pathogenic bacteria including Acinetobacter, Enterobacter and Proteobacteria and the decreased abundance of beneficial bacteria including Actinobacteriota, Bifidobacteriales, Prevotellaceae, and Lactobacillus were found in UUO group. After the administration of KXL, the growth of potential pathogenic bacteria was reduced and the abundance of beneficial bacteria was enhanced. Conclusion KXL displays a therapeutical potential in protecting renal function and inhibiting RF, and its mechanism of action may be associated with regulating intestinal microbiota.

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Section: Discussionmentioning

confidence: 99%

Kangxianling formula attenuates renal fibrosis by regulating gut microbiota

Tao,

Liu,

Hou

et al. 2024

Eur J Med Res

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Shear‐Wave Elastography Improves Diagnostic Accuracy in Chronic Kidney Disease Compared to Conventional Ultrasound

Jiang,

Zang,

Gao

et al. 2024

J of Clinical Ultrasound

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PurposeNon‐invasive tests are increasingly demanded for diagnosing and prognostication of chronic kidney disease (CKD). Shear‐wave elastography (SWE), an emerging technique for measuring tissue stiffness, shows promise for distinguishing between individuals with different stages of renal fibrosis. This study aimed to compare the diagnostic accuracy of two‐dimensional SWE (2D‐SWE) and conventional ultrasound for detecting CKD, employing renal biopsy as the gold standard.MethodsFrom May 2020 to October 2023, this prospective study included 30 healthy volunteers and 169 patients with CKD who had undergone 2D‐SWE and conventional ultrasound of both kidneys. Cortical and medullary stiffness, cortical pixel intensity, renal length, parenchymal and cortical thickness, interlobar artery peak systolic velocity, end‐diastolic velocity (EDV), and resistive index were measured. The diagnostic accuracy of 2D‐SWE and conventional ultrasound was compared using the receiver operating characteristic curve (ROC) and Delong test.ResultsFor diagnosing CKD, the area under the ROC (AUC) of cortical stiffness (0.96 [95% CI, 0.93, 0.99]) was significantly higher than that of all conventional ultrasound parameters, including EDV (0.78 [95% CI, 0.71, 0.86]) and cortical thickness (0.74 [95% CI, 0.67, 0.80]). The sensitivity of cortical stiffness (91%) was significantly higher than that of EDV (68%) and cortical thickness (53%). No significant difference was found in the specificity of cortical stiffness (96%) compared to that of EDV (79%) and cortical thickness (100%).ConclusionTwo‐dimensional SWE showed higher diagnostic accuracy than that of conventional ultrasound for detecting CKD.

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