Multiparametric MRI assessment of renal structure and function in acute kidney injury and renal recovery

Buchanan, Charlotte; Mahmoud, Huda; Cox, Eleanor; Noble, Rebecca; Prestwich, Benjamin; Kasmi, Isma; Taal, Maarten W; Francis, Susan; Selby, Nicholas M

Abstract

Background: Acute Kidney Injury (AKI) is associated with a marked increase in mortality as well as subsequent chronic kidney disease (CKD) and end stage kidney disease. We performed multiparametric MRI with the aim of identifying potential non-invasive MRI markers of renal pathophysiology in AKI and during recovery.
Methods: Nine participants underwent inpatient MRI scans at time of AKI; seven had follow-up scans at 3-months and 1-year following AKI. Multiparametric renal MRI assessed total kidney volume (TKV), renal perfusion using arterial spin labelling, T1 mapping and BOLD R2* mapping.
Results: Serum creatinine concentration had recovered to baseline levels at 1-year post-AKI in all participants. At time of AKI, participants had increased TKV, increased cortex/medulla T1, and reduced cortical perfusion compared to the expected ranges in healthy volunteers and people with CKD. TKV and T1 values decreased over time after AKI and returned to expected values in most but not all patients by 1-year. Cortical perfusion improved to a lesser extent and remained below the expected range in the majority of patients by 1-year post-AKI. BOLD R2* data showed a non-significant trend to increase over time post-AKI.
Conclusion: We observed a substantial increase in TKV and T1 during AKI and a marked decrease in cortical perfusion. Despite biochemical recovery at 1-year post-AKI, MRI measures indicated persisting abnormalities in some patients. We propose that such patients may be more likely to have further AKI episodes or progress to CKD and further longitudinal studies are required to investigate this.

Citation

Buchanan, C., Mahmoud, H., Cox, E., Noble, R., Prestwich, B., Kasmi, I., …Selby, N. M. (2021). Multiparametric MRI assessment of renal structure and function in acute kidney injury and renal recovery. Clinical Kidney Journal, 14(8), 1969-1976. https://doi.org/10.1093/ckj/sfaa221

• Journal Article Type: Article
• Acceptance Date: Sep 17, 2020
• Online Publication Date: Feb 10, 2021
• Publication Date: 2021-08
• Deposit Date: Sep 17, 2020
• Publicly Available Date: Feb 10, 2021
• Journal: Clinical Kidney Journal
• Print ISSN: 2048-8505
• Electronic ISSN: 2048-8513
• Publisher: Oxford University Press
• Peer Reviewed: Peer Reviewed
• Volume: 14
• Issue: 8
• Pages: 1969-1976
• DOI: https://doi.org/10.1093/ckj/sfaa221
• Public URL: https://nottingham-repository.worktribe.com/output/4910531
• Publisher URL: https://academic.oup.com/ckj/article/14/8/1969/6132064