Renal ultrasonographic shear-wave elastography and urinary procollagen type III amino-terminal propeptide in chronic kidney disease dogs

Abstract

Background and Aim: Renal fibrosis is a well-established pathological alteration associated with chronic kidney disease (CKD) in several species and progresses as CKD advances. Although a renal biopsy is the gold standard for determining renal fibrosis, it is an invasive, impractical method for clinical practice. In humans, ultrasonographic shear-wave elastography (SWE), a novel advanced diagnostic imaging tool, can evaluate renal parenchyma stiffness, and urinary procollagen type III amino-terminal propeptide (uPIIINP), a promising renal fibrosis biomarker in humans, has increasingly been use applied to reduce the biopsies. This study compares renal tissue elasticity observed through SWE Young's modulus (E) values between healthy dogs (HD) and those with CKD. Materials and Methods: The E value acquired by SWE, uPIIINP levels, and renal function were evaluated in 15 CKD dogs and 15 HD. Results: The renal cortical E values were significantly higher than the renal medullary E values in both groups (p<0.001). Renal cortical and medullary E values in CKD dogs were significantly higher than in HD (p<0.01). Cortical E values had greater significant correlations with renal functional parameters than the medullary E values and had a significant positive correlation with concentrations of plasma creatinine (Cr) (p<0.001); blood urea nitrogen (p<0.01); urine protein Cr ratio (p<0.01); and fractional excretions of sodium (p<0.05), potassium (p<0.05), chloride (p<0.05), and magnesium (p<0.001) while they had a negative correlation with urine specific gravity (p<0.05) and urine osmolality to plasma osmolality ratio (p<0.05). The uPIIINP to Cr (uPIIINP/Cr) ratios of CKD dogs were higher than those of HD (p<0.001). Moreover, the uPIIINP/Cr levels presented significant correlations with the renal cortical E values (p<0.01) and also the renal functional parameters. Conclusion: SWE offers a complementary, non-invasive diagnostic imaging tool for evaluating renal tissue stiffness in CKD dogs with renal function deterioration. In addition, uPIIINP levels are associated with renal function and structural changes in dogs. Therefore, the uPIIINP level might be a non-invasive, complementary, and promising biomarker for evaluating renal fibrosis in canine CKD.

Quantitative studies on B‐mode ultrasound and point shear wave elastography of kidneys in nonazotemic dogs

“…In our study, the utilization of the EPQ software package contributed to the lower pSWE values compared with previous reports. Furthermore, bettering previous reports, in the present study, the sample size was relatively larger, and SWE values were expressed both in m/s and kPa 23,25,26 . The YMSV values of the total kidney in our study were comparable to Leong et al., 20 who reported 3.55 kPa for healthy human kidneys using the EPQ software package.…”

Effectiveness of 2‐dimensional shear wave elastography for noninvasive and reliable estimation of right atrial pressure in dogs with induced volume overload

“… 7 , 8 SWV is reported in meters per second, and its elevation shows a higher elastic modulus in the organ. In veterinary medicine, these investigations were used in previous studies to predict hepatic fibrosis, 9 discriminate metastatic and nonmetastatic lymph nodes, 10 evaluate renal tissue stiffness, 11 distinguish benign and malignant mammary gland neoplasms, 12 and in dogs with extrahepatic biliary obstruction. 13 In addition, a recent veterinary research evaluated the influence of anesthesia to a hepatic elastic modulus measured by 2D‐SWE; however, the results have been inconsistent, with a study reporting a higher elastic modulus in anesthetized than in awake dogs, 14 and another showing the opposite effect.…”

Diagnostic assessment of two-dimensional shear wave elastography in relation to dimethyl arginine levels in dogs with chronic kidney disease

“…Chronic kidney disease (CKD) is the most common renal disease in older dogs, affecting approximately 0.5%–1.5% of all dogs [ 1 2 ]. CKD is typically progressive and irreversible [ 1 3 ].…”

“…CKD is typically progressive and irreversible [ 1 3 ]. Therefore, early diagnosis of CKD is essential for initiating proper treatment to prevent severe, progressive renal damage [ 2 3 ]. Although histological examination is considered the gold standard to diagnose CKD [ 3 4 ].…”

“…The feasibility of shear wave elastography in diagnosing CKD remains quite controversial in humans [ 11 ]. In veterinary medicine, few studies have been reported to assess the application of SWE in CKD [ 2 14 15 ]. Previous studies revealed that CKD groups had a higher renal SWV than control groups in dogs and cats [ 2 15 ].…”