Hassib Chehade1, Bastien Milani2, Annalisa Ansaloni2, Christiane Anex2, Isabelle Bassi2, Maciej Piskunowicz2,3, Matthias Stuber4, Francois Cachat5, Michel Burnier2, Menno Pruijm2. 1. Pediatric Nephrology Unit, Department of Pediatrics, University Hospital of Lausanne (CHUV), Rue Bugnon 46, 1011, Lausanne, Switzerland. hassib.chehade@chuv.ch. 2. Service of Nephrology and Hypertension, University Hospital of Lausanne (CHUV), Lausanne, Switzerland. 3. Radiology Department, Medical University of Gdansk, Gdansk, Poland. 4. Center for Biomedical Imaging (CIBM), Lausanne, Switzerland. 5. Pediatric Nephrology Unit, Department of Pediatrics, University Hospital of Lausanne (CHUV), Rue Bugnon 46, 1011, Lausanne, Switzerland.
Abstract
BACKGROUND: Vesicoureteral reflux (VUR) is a frequent cause of chronic kidney disease (CKD) in children. Using blood oxygenation level-dependent magnetic resonance imaging (BOLD-MRI), we measured cortical and medullary oxygenation in children with CKD due to VUR and compared the results to those obtained on healthy controls. METHOD: The study population comprised 37 children (19 with CKD due to VUR and 18 healthy age-matched controls). BOLD-MRI was performed before and after furosemide treatment. MR images were analyzed with the region-of-interest (ROI) technique to assess the mean R2* values (=1/T2*) of the cortex and medulla of each kidney and with the concentric object (CO) technique that divides renal parenchyma in 12 equal layers. RESULTS: R2* values were significantly lower (corresponding to higher oxygenation) in the cortex and medulla of kidneys of children with CKD due to VUR than in those of the healthy controls (cortex 16.4 ± 1.4 vs. 17.2 ± 1.6 s(-1) , respectively; medulla 28.4 ± 3.2 vs. 30.3 ± 1.9 s(-1) , respectively; P < 0.05), and furosemide-induced changes in medullary R2* were smaller in the former than in the latter (-5.7 ± 3.0 vs. -6.9 ± 3.4 s(-1), respectively; P < 0.05). Similar results were found with the CO technique. In children with a history of unilateral reflux (n = 9), the non-affected contralateral kidneys presented similar R2* values as the diseased kidneys, but their response to furosemide was significantly larger (-7.4 ± 3.2 vs. -5.7 ± 3.0, respectively; P = 0.05). CONCLUSIONS: Chronic kidney disease due to VUR is not associated with kidney tissue hypoxia in children. The significantly larger furosemide-induced decrease in medullary R2* levels in the healthy group and unaffected contralateral kidneys of the VUR group points towards more intense renal sodium transport in these kidneys.
BACKGROUND: Vesicoureteral reflux (VUR) is a frequent cause of chronic kidney disease (CKD) in children. Using blood oxygenation level-dependent magnetic resonance imaging (BOLD-MRI), we measured cortical and medullary oxygenation in children with CKD due to VUR and compared the results to those obtained on healthy controls. METHOD: The study population comprised 37 children (19 with CKD due to VUR and 18 healthy age-matched controls). BOLD-MRI was performed before and after furosemide treatment. MR images were analyzed with the region-of-interest (ROI) technique to assess the mean R2* values (=1/T2*) of the cortex and medulla of each kidney and with the concentric object (CO) technique that divides renal parenchyma in 12 equal layers. RESULTS: R2* values were significantly lower (corresponding to higher oxygenation) in the cortex and medulla of kidneys of children with CKD due to VUR than in those of the healthy controls (cortex 16.4 ± 1.4 vs. 17.2 ± 1.6 s(-1) , respectively; medulla 28.4 ± 3.2 vs. 30.3 ± 1.9 s(-1) , respectively; P < 0.05), and furosemide-induced changes in medullary R2* were smaller in the former than in the latter (-5.7 ± 3.0 vs. -6.9 ± 3.4 s(-1), respectively; P < 0.05). Similar results were found with the CO technique. In children with a history of unilateral reflux (n = 9), the non-affected contralateral kidneys presented similar R2* values as the diseased kidneys, but their response to furosemide was significantly larger (-7.4 ± 3.2 vs. -5.7 ± 3.0, respectively; P = 0.05). CONCLUSIONS:Chronic kidney disease due to VUR is not associated with kidney tissue hypoxia in children. The significantly larger furosemide-induced decrease in medullary R2* levels in the healthy group and unaffected contralateral kidneys of the VUR group points towards more intense renal sodium transport in these kidneys.
Authors: Arjang Djamali; Elizabeth A Sadowski; Rebecca J Muehrer; Shannon Reese; Chanigan Smavatkul; Aparna Vidyasagar; Sean B Fain; Ryan C Lipscomb; Debra H Hullett; Millie Samaniego-Picota; Thomas M Grist; Bryan N Becker Journal: Am J Physiol Renal Physiol Date: 2006-10-24
Authors: Edward Pivin; Belen Ponte; Menno Pruijm; Daniel Ackermann; Idris Guessous; Georg Ehret; Yan-Ping Liu; Nadja E A Drummen; Marjo H J Knapen; Antoinette Pechere-Bertschi; Fred Paccaud; Markus Mohaupt; Cees Vermeer; Jan A Staessen; Bruno Vogt; Pierre-Yves Martin; Michel Burnier; Murielle Bochud Journal: Hypertension Date: 2015-05-18 Impact factor: 10.190