Abstract
Renal hypoxia has recently been implicated as a key contributor and indicator of various glomerular diseases. As such, monitoring changes in renal oxygenation in these disorders may provide an early diagnostic advantage that could prevent potential adverse outcomes. Blood oxygen level-dependent magnetic resonance imaging (BOLD MRI) is an emerging noninvasive technique for assessing renal oxygenation in glomerular disease. Although BOLD MRI has produced promising initial results for the use in certain renal pathologies, the use of BOLD imaging in glomerular diseases, including primary and secondary nephrotic and nephritic syndromes, is relatively unexplored. Early BOLD studies on primary nephrotic syndrome, nephrotic syndrome secondary to diabetes mellitus, and nephritic syndrome secondary to systemic lupus erythematosus have shown promising results to support its future clinical utility. In this review, we outline the advancements made in understanding the use of BOLD MRI for the assessment, diagnosis, and screening of these pathologies.
Highlights
Glomerular disease continues to be a large health burden worldwide, often occurring as a primary process or as secondary to systemic inflammatory conditions, infections, and diabetes mellitus [1]
Uncontrolled diabetes mellitus can lead to diabetic nephropathy (DN), which can later present as a secondary nephrotic syndrome
blood oxygenlevel-dependent level-dependent (BOLD) MRI was initially used for cerebrovascular imaging, its use in other organ systems is being increasingly explored
Summary
Glomerular disease continues to be a large health burden worldwide, often occurring as a primary process or as secondary to systemic inflammatory conditions, infections, and diabetes mellitus [1]. In the past 10 years, multiple studies have implicated renal hypoxia in glomerular disease [2,3,4]. Increasing amounts of deoxyhemoglobin induce an internal magnetic field and phase dispersions of neighboring spin states, which distorts the MRI signal These results are reported as the R2* (sec−1 ) value, which is the apparent relaxation rate and indicates the relative content of deoxyhemoglobin. BOLD as aas primary fMRI technique, often using it for and neurosurgeons consistently employ a primary technique, often using it for pre-operative analysis as well as other applications such as seizure tracking. MRI maytool be an effective tool progression [8] These studies have found that for renal imaging, a to track disease progression [8]. MRI’s use syndrome, in primary secondary nephrotic syndrome due to diabetes mellitus, due and secondary nephrotic syndrome, secondary nephrotic syndrome to diabetesnephritic mellitus,syndrome and secdue to systemic erythematosus (SLE). lupus erythematosus (SLE)
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