The association between renal elasticity evaluated by Real-time tissue elastography and renal fibrosis

Makita, Ayu; Nagao, Tetsuhiko; Miyoshi, Katsuhiko; Kurata, Mie; Kondo, Fumikazu; Shichijo, Satoru; Hirooka, Masashi; Yamaguchi, Osamu

doi:10.1007/s10157-021-02063-2

Cited by 14 publications

(5 citation statements)

References 29 publications

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“…Matrix accumulation can cause organ stiffness, which is likely responsible for organ failure in pulmonary and heart fibrosis (21)(22)(23). As the role of tissue elasticity in kidney function regulation is not immediately obvious (24), the mechanism by which matrix accumulation (or fibrosis) affects kidney function has been controversial (25,26). Kidney function only modestly correlate with fibrosis (r = 0.4) (18,27).…”

Section: Introductionmentioning

confidence: 99%

“…Matrix accumulation can cause organ stiffness, which is implicated in organ failure in cases of pulmonary and heart fibrosis [18][19][20] . The role of tissue elasticity in the regulation of kidney function is not clear 21 , and thus, the mechanism by which matrix accumulation (or fibrosis) influences kidney function remains a subject of controversy 22,23 .…”

Section: Introductionmentioning

confidence: 99%

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Spatially resolved human kidney multi-omics single cell atlas highlights the key role of the fibrotic microenvironment in kidney disease progression

Abedini

Frederick

et al. 2022

Preprint

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Kidneys have one of the most complex three-dimensional cellular organizations in the body, but the spatial molecular principles of kidney health and disease are poorly understood. Here we generate high-quality single cell (sc), single nuclear (sn), spatial (sp) RNA expression and sn open chromatin datasets for 73 samples, capturing half a million cells from healthy, diabetic, and hypertensive diseased human kidneys. Combining the sn/sc and sp RNA information, we identify > 100 cell types and states and successfully map them back to their spatial locations. Computational deconvolution of spRNA-seq identifies glomerular/vascular, tubular, immune, and fibrotic spatial microenvironments (FMEs). Although injured proximal tubule cells appear to be the nidus of fibrosis, we reveal the complex, heterogenous cellular and spatial organization of human FMEs, including the highly intricate and organized immune environment. We demonstrate the clinical utility of the FME spatial gene signature for the classification of a large number of human kidneys for disease severity and prognosis. We provide a comprehensive spatially-resolved molecular roadmap for the human kidney and the fibrotic process and demonstrate the clinical utility of spatial transcriptomics.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Spatially resolved human kidney multi-omics single cell atlas highlights the key role of the fibrotic microenvironment in kidney disease progression

Abedini

Frederick

et al. 2022

Preprint

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“…The kidneys are enclosed in a fibrous renal capsule, which reflects renal stiffness and is sensitive to changes in perfusion pressure. An increase in vascularization seems to be correlated with an increase in stiffness and, consequently, an increase in the propagation speed of the waves; on the contrary, a decrease in the blood supply to the kidney is responsible for a reduction in the stiffness of the renal parenchyma [20][21][22][23].…”

Section: Discussionmentioning

confidence: 98%

Using Renal Elastography to Predict the Therapeutic Response of Nephrological Patients

Mancianti,

Garosi,

Iadanza

et al. 2023

JCM

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Background: The standard method for assessing chronic renal damage is renal biopsy, which has limitations due to its invasiveness. Ultrasound elastography is a non-invasive technique that quantifies tissue elasticity and can be used to determine Young’s modulus (YM). Although this breakthrough technology has been successfully employed to evaluate liver stiffness and the extent of fibrosis, its application in kidney-related conditions still needs improvement. Methods: Our study aimed to verify the correlation between renal elastography and the chronic histological score determined via renal biopsy, evaluate the correlation between elastography and response to treatment in the short-term follow-up (6 months), and compare elastography data between renal disease patients (AKD-P) and healthy controls (HP). Results: The analyzed population consisted of 82 patients (41 HP and 41 AKD-P). The AKD-P were divided into responders (R) or non-responders (NR) based on the criteria established by the guidelines. No association was found between renal stiffness and chronic histological score. Elastography data revealed median YM values of 6.15 kPa for AKD-P and 12.2 kPa for HP, with a statistically significant difference. The median YM values of the R and NR groups were 7.4 KPa and 5.6 KPa, respectively (p = 0.037). Conclusions: Patient responsiveness was associated with YM, with lower values observed in the NR group. We also found that the healthy controls exhibited significantly higher YM values than the renal disease population.

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“…Among them are ultrasound technologies that can measure renal stiffness using transient elastography (4), supersonic shear imaging (5,6), and shear wave elastography (7)(8)(9). Still, these studies showed conflicting results regarding the correlation of renal stiffness with fibrosis (7,8) or no correlation at all (10)(11)(12). Other studies have tested magnetic resonance imaging (MRI)-based approaches, notably using diffusion-weighted imaging (13,14) and magnetic resonance elastography (MRE) (15)(16)(17)(18).…”

Section: Introductionmentioning

confidence: 99%

Magnetic Resonance Elastography as Surrogate Marker of Interstitial Fibrosis in Kidney Transplantation: A Prospective Study

et al. 2022

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Background: Fibrosis progression is a major prognosis factor in kidney transplantation. Its assessment requires an allograft biopsy, which remains an invasive procedure at risk of complications. Methods: We assessed renal stiffness by magnetic resonance elastography (MRE) as a surrogate marker of fibrosis in a prospective cohort of kidney transplant recipients, as compared to the histological gold standard. Interstitial fibrosis was evaluated by three methods: the semi-quantitative Banff ci score, a visual quantitative evaluation by a pathologist and a computer-assisted quantitative evaluation. MRE-derived stiffness was assessed at the superior, median and inferior poles of the allograft. Results: We initially enrolled 73 patients, but only 55 had measurements of their allograft stiffness by MRE prior to an allograft biopsy. There was no significant correlation between MRE-derived stiffness at biopsy site and the ci score (rho=-0.25, p=0.06) or with the two quantitative assessments (pathologist, rho=-0.25, p=0.07, computer-assisted, rho=-0.21, p=0.12). We observed negative correlations between the stiffness of both biopsy site and whole allograft, with either the glomerulosclerosis percentage (rho=-0.32, p=0.02 and rho=-0.31, p=0.02, respectively) and the overall nephron fibrosis percentage, defined as the mean of the percentages of glomerulosclerosis and interstitial fibrosis (rho=-0.30, p=0.02 and rho=-0.28, p=0.04, respectively). At patient level, mean MRE-derived stiffness was similar across the three poles of the allograft (± 0.25 kPa). However, a high variability of mean stiffness was found between patients, suggesting a strong influence of confounding factors. Finally, no significant correlation was found between mean MRE-derived stiffness and the slope of eGFR (p=0.08). Conclusions: MRE-derived stiffness does not directly reflect the extent of fibrosis in kidney transplantation.

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The association between renal elasticity evaluated by Real-time tissue elastography and renal fibrosis

Cited by 14 publications

References 29 publications

Spatially resolved human kidney multi-omics single cell atlas highlights the key role of the fibrotic microenvironment in kidney disease progression

Spatially resolved human kidney multi-omics single cell atlas highlights the key role of the fibrotic microenvironment in kidney disease progression

Using Renal Elastography to Predict the Therapeutic Response of Nephrological Patients

Magnetic Resonance Elastography as Surrogate Marker of Interstitial Fibrosis in Kidney Transplantation: A Prospective Study

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