Declèves AE, Rychak JJ, Smith DJ, Sharma K. Effects of high-fat diet and losartan on renal cortical blood flow using contrast ultrasound imaging. Am J Physiol Renal Physiol 305: F1343-F1351, 2013. First published September 18, 2013 doi:10.1152/ajprenal.00326.2013.-Obesity-related kidney disease occurs as a result of complex interactions between metabolic and hemodynamic effects. Changes in microvascular perfusion may play a major role in kidney disease; however, these changes are difficult to assess in vivo. Here, we used perfusion ultrasound imaging to evaluate cortical blood flow in a mouse model of high-fat diet-induced kidney disease. C57BL/6J mice were randomized to a standard diet (STD) or a high-fat diet (HFD) for 30 wk and then treated either with losartan or a placebo for an additional 6 wk. Noninvasive ultrasound perfusion imaging of the kidney was performed during infusion of a microbubble contrast agent. Blood flow within the microvasculature of the renal cortex and medulla was derived from imaging data. An increase in the time required to achieve full cortical perfusion was observed for HFD mice relative to STD. This was reversed following treatment with losartan. These data were concurrent with an increased glomerular filtration rate in HFD mice compared with STD-or HFD-losartan-treated mice. Losartan treatment also abrogated fibro-inflammatory disease, assessed by markers at the protein and messenger level. Finally, a reduction in capillary density was found in HFD mice, and this was reversed upon losartan treatment. This suggests that alterations in vascular density may be responsible for the elevated perfusion time observed by imaging. These data demonstrate that ultrasound contrast imaging is a robust and sensitive method for evaluating changes in renal microvascular perfusion and that cortical perfusion time may be a useful parameter for evaluating obesity-related renal disease. ultrasound contrast imaging; obesity-related kidney disease; renal perfusion THE GROWING EPIDEMIC OF OBESITY is a serious health and economic burden throughout the world. The consequence of obesity over time is characterized by insulin resistance, hyperglycemia, atherosclerosis, dyslipidemia, and hypertension. This cluster of risk factors referred to as metabolic syndrome occurs with 50% prevalence in patients 50-to 60-yr-old (4) and contributes to cardiovascular disease. Obesity is a major risk factor for diabetes and hypertension, which together account for ϳ70% of all cases of end-stage renal disease (6). However, there is growing evidence suggesting that obesity by itself may be an independent risk factor for the development of vascular dysfunction and renal disease (21,44,66). Obesity-related kidney disease occurs as a result of complex interactions between metabolic and hemodynamic factors and is characterized by changes of renal perfusion, vascular dysfunction, as well as albuminuria, glomerulosclerosis, and tubulointerstitial fibrosis (20,37,48,50). Alterations in blood flow within the cortex or the medulla ma...