DWI as a biomarker of renal function in children with CKD: what is the potential?

Abstract

Background: Evaluation of renal microstructure is pivotal for diagnosing and monitoring chronic renal disease. DWI has been proved to be practicable and reliable examination for the assessment of renal function and parenchymal damage in some renal diseases. Our aim is to appraise DWI sequence and ADC measurement as a potential tool of renal function assessment as well as establishing a possible relationship between the different CKD stages and the renal parenchymal ADC values changes. Results: Regarding the cause of CKD, nine patients (45%) had glomerulonephritis, 5 patients (25%) had hemolytic uremic syndrome, 2 patients (10%) had lupus nephritis, 2 patients (10%) had nepheronophthisis, and 1 patient (1.5%) had infantile nepherosis, whereas the cause of CKD was unknown in 1 patient (1.5%). The stages of CKD were classified according to KIDGO guidelines: 6 patients (30%) were stage 1, 4 patients (20%) were stage 2, 3 patients (15%) were stage 3, 2 patients (10%) were stage 4, and 5 patients (25%) were stage 5. The patients' group (group A) had a mean ADC value (1.85 × 10 −3 ± 0.24) which was significantly lower than that of the control group (group B) (2.21 × 10 −3 ± 0.12). As for the correlation between stage of CKD and ADC, we found it to be a moderate negative one with r' value of − .655 and a significant p value of < 0.001. Conclusion: DWI is recognized as a promising imaging tool that can take part in the assessment of the morphological and functional changes in diffuse renal parenchymal disease, hence playing an important role in the early diagnosis and staging of chronic kidney disease.

Does diffusion-weighted magnetic resonance imaging help in the detection of renal parenchymal disease and staging/prognostication in chronic kidney disease?

“…Eldin et al . [ 16 ] reported a comparable average ADC value of the kidneys in cases at 1.85 × 10 –3 ± 0.24 mm 2 /s, with a minimum of 1.20 and a maximum of 2.30. Likewise, in our study the average ADC value was 2.00 × 10 –3 mm 2 /s, with a minimum of 1.75 and maximum of 2.28.…”

Recent advances in medical image processing for the evaluation of chronic kidney disease

“…A significant decline in mean ADC values was found among patients with advanced stages of Diabetic Nephropathy (DN), a main cause leading to renal failure, compared to diabetic patients with no nephropathy (Jawad, 2019). Recently, DWI was proved to be promising to differentiate healthy and CKD children (glomerulonephritis, hemolytic uremic syndrome, lupus nephritis (LN), nepheronophthisis and infantile nephrosis were the main causes of CKD) (Emad-Eldin et al, 2020). ADCs were negatively correlated to CKD stages (stage I to V) (Emad-Eldin et al, 2020).…”

“…Recently, DWI was proved to be promising to differentiate healthy and CKD children (glomerulonephritis, hemolytic uremic syndrome, lupus nephritis (LN), nepheronophthisis and infantile nephrosis were the main causes of CKD) (Emad-Eldin et al, 2020). ADCs were negatively correlated to CKD stages (stage I to V) (Emad-Eldin et al, 2020). Cortical as well as medullary ADCS were reported to be decreased significantly with the presence of renal allograft dysfunction (mean eGFR of 30 ml/min/1.73 m 2 ) associated with fibrosis deposition (Bane et al, 2020).…”