Abstract
The kidneys are essential for maintaining homeostasis, are responsible for the reabsorption of water, glucose and amino acids, and filter the blood by removing waste. Acute kidney injury (AKI) is a syndrome characterized by the rapid loss of renal excretory function and the accumulation of end metabolic products of urea and creatinine. AKI is associated with the later development of chronic kidney disease and end-stage kidney disease, and may eventually be fatal. Early diagnosis of AKI and assessments of the effects of treatment, however, are challenging. The pathophysiological mechanism of AKI is thought to be the imbalance between oxygen supply and demand in the kidneys. We have assessed the ability of arterial spin labeling (ASL) perfusion magnetic resonance imaging (MRI), without the administration of contrast media, to quantify renal blood flow (RBF) non-invasively. We found that RBF was significantly lower in AKI patients than in healthy volunteers. These results suggest that ASL perfusion MRI, a noninvasive measurement of RBF, may be useful in the early diagnosis of AKI.
Highlights
Acute kidney injury (AKI) is a frequently observed condition linked with the later development of chronic kidney disease, end-stage kidney disease, and mortality
The results suggest that this noninvasive method, using flow-sensitive alternating inversion recovery (FAIR)-single shot fast spin echo (SSFSE) sequences, yields reliable quantitative measurements of renal blood flow (RBF) in both AKI patients and healthy volunteers without administration of contrast media
Using the nonlinear image registration method, arterial spin labeling (ASL) images can be acquired with acceptable quality for calculating perfusion maps of RBF
Summary
Acute kidney injury (AKI) is a frequently observed condition linked with the later development of chronic kidney disease, end-stage kidney disease, and mortality. The advent of the RIFLE (risk, injury, failure, loss, end-stage kidney disease) and Acute Kidney Injury Network (AKIN) criteria has improved the diagnosis of AKI [4], and decreased renal blood flow (RBF), which causes renal ischemia, has been proposed as central to the pathogenesis of septic acute renal failure [5]. These criteria, have been based on serum creatinine concentration and urine output, both of which have relatively poor specificity and sensitivity during the early period of AKI [6,7,8,9].
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