Measurement of renal blood flow by phase-contrast magnetic resonance imaging during septic acute kidney injury

Abstract

Cine phase-contrast magnetic resonance imaging can be used to noninvasively and safely assess renal perfusion during critical illness in man. Near-simultaneous accurate measurement of cardiac output enables organ blood flow to be assessed in the context of the global circulation. Renal blood flow seems consistently reduced as a fraction of cardiac output in established septic acute kidney injury. Cine phase-contrast magnetic resonance imaging may be a valuable tool to further investigate renal blood flow and the effects of therapies on renal blood flow in critical illness.

Renal Relevant Radiology

“…Although their assessment has been more common in renovascular disease, such as renal artery stenosis, it can be useful in other pathologic conditions that affect the microvasculature, renal blood flow, vascular resistance, or permeability such as CKD, hypertension, metabolic syndrome, diabetes, and sepsis (1). Moreover, perfusion measurement may help guide kidney transplant management and treatment of renal lesions (Table 2).…”

Renal Hemodynamics in AKI

“…[2][3][4][5] The causative contribution of renal blood flow (RBF) to kidney dysfunction is particularly puzzling in sepsis, and there is widespread disagreement as to whether RBF is reduced, normal, or even increased. 2,3,[6][7][8] In the few large animal and clinical studies, the patterns of RBF in AKI and its relation with systemic hemodynamics are highly variable. 3,6 Absence of benefit of vasodilator therapy in human sepsis-associated AKI 9 may be explained by variability in blood flow.…”

“…2,3,[6][7][8] In the few large animal and clinical studies, the patterns of RBF in AKI and its relation with systemic hemodynamics are highly variable. 3,6 Absence of benefit of vasodilator therapy in human sepsis-associated AKI 9 may be explained by variability in blood flow. Unfortunately, more specific knowledge about the relationship between RBF and AKI in sepsis is limited by the lack of reliable methods to monitor continuous RBF in human AKI.…”

Measurement of kidney perfusion in critically ill Patients

“…King et al [52] used this method as a tool to predict clinical response after percutaneous angioplasty in renal artery stenosis. This technique has recently been used in critically ill patients to determine renal blood flow in sepsis [53]. To the best of our knowledge, this study was the first to measure global renal blood flow noninvasively in critically ill patients with sepsis associated AKI.…”