Florian Siedek1, Thorsten Persigehl2, Roman-Ulrich Mueller3, Volker Burst3, Thomas Benzing3, David Maintz2, Stefan Haneder2. 1. Institute of Diagnostic and Interventional Radiology, University Hospital of Cologne, Kerpener Str. 62, 50937, Cologne, Germany. florian.siedek@uk-koeln.de. 2. Institute of Diagnostic and Interventional Radiology, University Hospital of Cologne, Kerpener Str. 62, 50937, Cologne, Germany. 3. Department II of Internal Medicine and Center for Molecular Medicine Cologne, University Hospital of Cologne, Kerpener Str. 62, 50937, Cologne, Germany.
Abstract
OBJECTIVE: Acute kidney injury (AKI) is an important risk factor for a number of adverse outcomes including end-stage renal disease and cardiovascular morbidity and mortality. Whilst many clinical situations that can induce AKI are known-e.g. drug toxicity, contrast agent exposure or ischemia during surgery-targeted preventive or therapeutic measures are still lacking. As to renoprotective strategies, remote ischemic preconditioning (RIPC) is one of the most promising novel approaches and has been examined by a number of clinical trials. The aim of this study was to use blood oxygenation level-dependent (BOLD) MRI as a surrogate parameter to assess the effect of RIPC in healthy volunteers. MATERIALS AND METHODS: In this IRB-approved, prospective study, 40 healthy volunteers were stratified with 20 undergoing an RIPC procedure (i.e. RIPC group) with a transient ischemia of the right arm, and 20 undergoing a sham procedure. Before and after the procedure, both kidneys of all participants were scanned using a 12-echo mGRE sequence for functional BOLD imaging at 3T. For each volunteer, 180 ROIs were placed in the cortex and the medulla of the kidneys. Ultimately, R2* values, which have an inverse correlation with the oxygenation level of tissue, were averaged for the RIPC and control groups. RESULTS: Following intervention, mean R2* values significantly decreased in the RIPC group in both the cortex (18.6 ± 2.3 vs. 17.5 ± 1.7 Hz; p = 0.0047) and medulla (34 ± 5.2 vs. 32.2 ± 4.2 Hz; p = 0.0001). However, no significant differences were observed in the control group. CONCLUSION: RIPC can be non-invasively assessed in healthy volunteers using BOLD MRI at 3T, demonstrating a higher oxygen content in kidney tissue. This study presents a first-in-man trial establishing a quantifiable readout of RIPC and its effects on kidney physiology. BOLD measurements may advance clinical trials in further evaluating RIPC for future clinical care.
OBJECTIVE:Acute kidney injury (AKI) is an important risk factor for a number of adverse outcomes including end-stage renal disease and cardiovascular morbidity and mortality. Whilst many clinical situations that can induce AKI are known-e.g. drug toxicity, contrast agent exposure or ischemia during surgery-targeted preventive or therapeutic measures are still lacking. As to renoprotective strategies, remote ischemic preconditioning (RIPC) is one of the most promising novel approaches and has been examined by a number of clinical trials. The aim of this study was to use blood oxygenation level-dependent (BOLD) MRI as a surrogate parameter to assess the effect of RIPC in healthy volunteers. MATERIALS AND METHODS: In this IRB-approved, prospective study, 40 healthy volunteers were stratified with 20 undergoing an RIPC procedure (i.e. RIPC group) with a transient ischemia of the right arm, and 20 undergoing a sham procedure. Before and after the procedure, both kidneys of all participants were scanned using a 12-echo mGRE sequence for functional BOLD imaging at 3T. For each volunteer, 180 ROIs were placed in the cortex and the medulla of the kidneys. Ultimately, R2* values, which have an inverse correlation with the oxygenation level of tissue, were averaged for the RIPC and control groups. RESULTS: Following intervention, mean R2* values significantly decreased in the RIPC group in both the cortex (18.6 ± 2.3 vs. 17.5 ± 1.7 Hz; p = 0.0047) and medulla (34 ± 5.2 vs. 32.2 ± 4.2 Hz; p = 0.0001). However, no significant differences were observed in the control group. CONCLUSION: RIPC can be non-invasively assessed in healthy volunteers using BOLD MRI at 3T, demonstrating a higher oxygen content in kidney tissue. This study presents a first-in-man trial establishing a quantifiable readout of RIPC and its effects on kidney physiology. BOLD measurements may advance clinical trials in further evaluating RIPC for future clinical care.
Authors: Lu-Ping Li; Anthony T Vu; Belinda S Y Li; Eugene Dunkle; Pottumarthi V Prasad Journal: J Magn Reson Imaging Date: 2004-11 Impact factor: 4.813
Authors: Patrick Meybohm; Berthold Bein; Oana Brosteanu; Jochen Cremer; Matthias Gruenewald; Christian Stoppe; Mark Coburn; Gereon Schaelte; Andreas Böning; Bernd Niemann; Jan Roesner; Frank Kletzin; Ulrich Strouhal; Christian Reyher; Rita Laufenberg-Feldmann; Marion Ferner; Ivo F Brandes; Martin Bauer; Sebastian N Stehr; Andreas Kortgen; Maria Wittmann; Georg Baumgarten; Tanja Meyer-Treschan; Peter Kienbaum; Matthias Heringlake; Julika Schön; Michael Sander; Sascha Treskatsch; Thorsten Smul; Ewa Wolwender; Thomas Schilling; Georg Fuernau; Dirk Hasenclever; Kai Zacharowski Journal: N Engl J Med Date: 2015-10-05 Impact factor: 91.245
Authors: Alexander Zarbock; John A Kellum; Hugo Van Aken; Christoph Schmidt; Mira Küllmar; Peter Rosenberger; Sven Martens; Dennis Görlich; Melanie Meersch Journal: Anesthesiology Date: 2017-05 Impact factor: 7.892
Authors: Rathan M Subramaniam; Catalina Suarez-Cuervo; Renee F Wilson; Sharon Turban; Allen Zhang; Cheryl Sherrod; Jonathan Aboagye; John Eng; Michael J Choi; Susan Hutfless; Eric B Bass Journal: Ann Intern Med Date: 2016-02-02 Impact factor: 25.391
Authors: Louisa Sukkar; Daqing Hong; Muh Geot Wong; Sunil V Badve; Kris Rogers; Vlado Perkovic; Michael Walsh; Xueqing Yu; Graham S Hillis; Martin Gallagher; Meg Jardine Journal: BMJ Date: 2016-11-07
Authors: Yabing Zhang; Xiyang Zhang; Dongmei Chi; Siyang Wang; Hua Wei; Hong Yu; Qian Li; Bin Liu Journal: Medicine (Baltimore) Date: 2016-09 Impact factor: 1.889
Authors: Karl Kuusik; Teele Kasepalu; Mihkel Zilmer; Jaan Eha; Mare Vähi; Liisi Anette Torop; Jüri Lieberg; Jaak Kals Journal: Oxid Med Cell Longev Date: 2021-12-08 Impact factor: 6.543