Abstract
Purpose: To assess the utility of non-contrast enhanced native T1 mapping of the renal cortex in assessing renal fibrosis for patients with chronic glomerulonephritis (CGN).Methods: A total of 119 patients with CGN and 19 healthy volunteers (HVs) were recruited for this study. Among these patients, 43 had undergone kidney biopsy measurements. Clinical information and biopsy pathological scores were collected. According to the results of the renal biopsy, the patients were classified into the high (25–50%), low (<25%) and no renal interstitial fibrosis (IF) (0%) groups. The correlations between the T1 value in the renal cortex and each of the clinical parameters were separately analyzed. The relationships between each fibrosis group and the T1 value were also evaluated and compared between groups. Binary logistic regression analysis was further used to determine the relationship between the T1 value and renal fibrosis. Receiver operating characteristic (ROC) curves were plotted to analyze the diagnostic value of the T1 value for renal fibrosis.Results: Compared with those of the HVs, the T1 values were significantly higher in patients at all stages of chronic kidney disease (CKD) (all p < 0.05). Significant T1 differences were also revealed between patients with different stages of CKD (p < 0.05). Additionally, the T1 value correlated well with CKD stage (p < 0.05), except between CKD 2 and 3. In addition, the T1 value was positively correlated with cystatin C, neutrophil gelatinase-associated lipocalin, and serum creatinine and negatively correlated with hemoglobin, kidney length, estimated glomerular filtration rate and hematocrit (all p < 0.05). Compared with those of the no IF group, the T1 values were increased in the low- and high-IF groups (both p < 0.05). Logistic regression analysis showed that an elevated T1 value was an independent risk factor for renal fibrosis. ROC analysis suggested that the optimal critical value of T1 for predicting renal fibrosis was 1,695 ms, with a specificity of 0.778 and a sensitivity of 0.625.Conclusion: Native T1 mapping demonstrated good diagnostic performance in evaluating renal function and was an effective noninvasive method for detecting renal fibrosis in CGN patients.
Highlights
Chronic kidney disease (CKD) has been increasingly recognized as a global public health problem [1]
Compared with those of the healthy volunteers (HVs), the T1 values were significantly higher in patients at all stages of chronic kidney disease (CKD)
The T1 value was positively correlated with cystatin C, neutrophil gelatinase-associated lipocalin, and serum creatinine and negatively correlated with hemoglobin, kidney length, estimated glomerular filtration rate and hematocrit
Summary
Chronic kidney disease (CKD) has been increasingly recognized as a global public health problem [1]. Chronic glomerulonephritis (CGN) remains the leading cause of CKD and end-stage renal disease (ESRD) in China [2]. Renal interstitial fibrosis is the abnormal deposition of collagen and associated proteins in the interstitium of the renal cortex. It is a common histological abnormality in all types of renal diseases and is considered to be a key predictor of renal functional recovery and prognosis in most renal diseases [3, 4]. Kidney biopsy is the gold standard for fibrosis evaluation; due to its shortcomings, such as its invasiveness and low reproducibility and the limited size of the collected sample, this method has not been widely implemented in the clinic [5]. There is a great clinical need for a method for noninvasively evaluating the degree of renal fibrosis
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