Measurement of renal tissue oxygenation with blood oxygen level-dependent MRI and oxygen transit modeling

Zhang, Jeff L.; Morrell, Glen; Rusinek, Henry; Warner, Lizette; Vivier, P.-H.; Cheung, Alfred K.; Lerman, Lilach O.; Lee, Vivian S.

doi:10.1152/ajprenal.00575.2013

Cited by 51 publications

(53 citation statements)

References 51 publications

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“…[20][21][22] Interestingly, chronic furosemide therapy attenuated the increase in medullary oxygenation after furosemide challenge in subjects with renal artery stenosis. 23 Zhang et al 5 evaluated the response to furosemide in pigs. They compared pO 2 modeled from BOLD MRI signals with direct measurements of pO 2 obtained with oxygen-sensing microelectrodes in a similarly treated group of animals.…”

Section: Diureticsmentioning

confidence: 99%

“…38 The authors underscored the observation that the T2* cortex to medulla ratio fell in the CKD subjects, but not in healthy volunteers; however, the significance of this observation may be questioned. 5 Perhaps these inconsistent results reflect different responses to acute versus chronic interruption of the renin/ angiotensin system. However, more general issues may have contributed to inconsistent results obtained by different investigators after the same intervention in the same disease state.…”

Section: Angiotensin IImentioning

confidence: 99%

“…1 The relationship between BOLD MRI signal intensity and renal oxygen tissue levels has been established by direct measurements of tissue pO 2 utilizing oxygen-sensing microelectrodes and fiberoptic probes in experimental models of streptozotocin-induced diabetes mellitus and aortic occlusion and before and after furosemide challenge and nitric oxide synthase inhibition, and by correlation with direct measurements of tissue pO 2 after changes in inhaled oxygen levels. [2][3][4][5][6][7] Numerous technical limitations confound interpretation of BOLD MRI measurements of renal oxygenation. 8 BOLD MRI signal intensity may be influenced by hydration status, sodium avidity, vascular volume, age, and perhaps the sex of the subjects studied.…”

Section: Introductionmentioning

confidence: 99%

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Blood oxygenation level-dependent MRI for assessment of renal oxygenation

Neugarten¹,

Golestaneh²

2014

IJNRD

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Blood oxygen level-dependent magnetic resonance imaging (BOLD MRI) has recently emerged as an important noninvasive technique to assess intrarenal oxygenation under physiologic and pathophysiologic conditions. Although this tool represents a major addition to our armamentarium of methodologies to investigate the role of hypoxia in the pathogenesis of acute kidney injury and progressive chronic kidney disease, numerous technical limitations confound interpretation of data derived from this approach. BOLD MRI has been utilized to assess intrarenal oxygenation in numerous experimental models of kidney disease and in human subjects with diabetic and nondiabetic chronic kidney disease, acute kidney injury, renal allograft rejection, contrast-associated nephropathy, and obstructive uropathy. However, confidence in conclusions based on data derived from BOLD MRI measurements will require continuing advances and technical refinements in the use of this technique.

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Section: Diureticsmentioning

confidence: 99%

Section: Angiotensin IImentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Blood oxygenation level-dependent MRI for assessment of renal oxygenation

Neugarten¹,

Golestaneh²

2014

IJNRD

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“…Blood oxygen level-dependent (BOLD)-MRI is a novel, powerful, and a noninvasive technique, which can assess renal oxygenation [6,7]. The validity of BOLD-MRI in assessing renal tissue oxygenation is supported by direct measurements of tissue O 2 content by oxygen-sensitive microelectrodes [8]. BOLD-MRI uses deoxyhemoglobin as an endogenous marker to assess renal tissue oxygenation: the higher renal deoxyhemoglobin, the higher the apparent relaxation rate R2* (1/ T2*), and the lower renal tissue oxygenation.…”

Section: Introductionmentioning

confidence: 99%

Renal Hypoxia: An Important Prognostic Marker in Patients with Chronic Kidney Disease

et al. 2018

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Background: Blood oxygen level-dependent (BOLD)-MRI is a novel and noninvasive tool that can assess renal oxygenation. The R2* value is a parameter of tissue deoxyhemoglobin concentration detected by BOLD-MRI. The purpose of the current study was to determine the relationships between renal R2* values and clinical parameters and to determine whether renal R2* values were associated with the risk for progression of chronic kidney disease (CKD). Methods: Sixty patients with CKD were enrolled in this prospective observational study in China from March 2013 to August 2014. A region of interest-based BOLD-MRI was performed to obtain cortical and medullary R2* (CR2* and MR2*) values. Data on demographics and clinical characteristics were collected. The primary end point (CKD progression) was defined as an absolute 30% decline in the estimated glomerular filtration rates (eGFR; CKD-Epidemiology Collaboration equations) or initiation of dialysis during follow-up. Results: The CR2* and MR2* values in patients with CKD were significantly higher compared with those of healthy controls. The CR2* levels were positively associated with 24-h urinary protein excretion, blood urea nitrogen, creatinine, and uric acid but negatively associated with baseline eGFR, 24-h creatinine clearance, eGFR slope, serum albumin, and the use of angiotensin II type 1 receptor blockade. The CR2* levels had the highest areas under the curve during follow-up compared with the MR2* levels and medullary cortical ratios. The Kaplan-Meier survival analysis showed that patients with CKD in the lowest tertile of the CR2* levels had the best prognosis compared with the other 2 tertiles. Moreover, baseline eGFR and CR2* tertiles were associated with the progression of CKD in Cox proportional hazard regression models. Only CR2* tertiles correlated negatively with the eGFR slope. Conclusion: We have demonstrated that the clinical feasibility of BOLD-MRI to evaluate renal oxygenation and cortex hypoxia aggravates with the decline of renal function, and cortex hypoxia was a prognostic marker in the progression of CKD.

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“…9 Oxygen availability can be evaluated indirectly based on blood oxygen level2dependent (BOLD) magnetic resonance imaging (MRI) using the paramagnetic property of deoxygenated hemoglobin (relaxation rate [R2*]), where high R2* values are indicative of low oxyhemoglobin content 10 and thus a surrogate for tissue oxygenation. 11 Only a few studies have been conducted in patients with CKD and results are conflicting. An investigation in patients with type 2 diabetes showed a clear association between GFR and medullary R2* values (MR2*), 12 whereas another study observed this only in individuals without diabetes.…”

mentioning

confidence: 99%