Abstract
AimsContrast-induced acute kidney injury (CI-AKI) is the third most common in-hospital acquired AKI, and its mechanism is not fully clear. Its morbidity increases among populations with chronic kidney disease (CKD), older age, diabetes mellitus (DM), and so on. Immediate and effective noninvasive diagnostic methods are lacking, so CI-AKI often prolongs hospital stays and increases extra medical costs. This study aims to explore the possibility of diagnosing CI-AKI with functional magnetic resonance imaging (fMRI) based on type 2 DM rats. Moreover, we attempt to reveal the immune response in CI-AKI and to clarify why DM is a predisposing factor for CI-AKI.MethodsA type 2 DM rat model was established by feeding a high-fat and high-sugar diet combined with streptozotocin (STZ) injection. Iodixanol-320 was the contrast medium (CM) administered to rats. Images were obtained with a SIEMENS Skyra 3.0-T magnetic resonance imager. Renal histopathology was evaluated using H&E staining and immunohistochemistry (IHC). The innate immune response was revealed through western blotting and flow cytometry.ResultsBlood oxygenation level-dependent (BOLD) imaging and intravoxel incoherent motion (IVIM) imaging can be used to predict and diagnose CI-AKI effectively. The R2∗ value (r > 0.6, P < 0.0001) and D value (| r| > 0.5, P < 0.0001) are strongly correlated with histopathological scores. The NOD-like receptor pyrin 3 (NLRP3) inflammasome participates in CI-AKI and exacerbates CI-AKI in DM rats. Moreover, the percentages of neutrophils and M1 macrophages increase dramatically in rat kidneys after CM injection (neutrophils range from 56.3 to 56.6% and M1 macrophages from 48 to 54.1% in normal rats, whereas neutrophils range from 85.5 to 92.4% and M1 macrophages from 82.1 to 89.8% in DM rats).Conclusions/interpretationBOLD and IVIM-D can be effective noninvasive tools in predicting CI-AKI. The innate immune response is activated during the progression of CI-AKI and DM will exacerbate this progression.
Highlights
Post-contrast acute kidney injury (PC-AKI) refers to a decrease in renal function after intravascular administration of contrast medium (CM; iodinate based)
In Groups A and B, R2∗ increased in the first 1 h after administration of iodixanol, and the color became darker at 24 h in Groups A and B than in Groups C and D
The two primary intentions of our study were to monitor the progression of contrast-induced AKI (CI-AKI) by Functional magnetic resonance imaging (fMRI) and to reveal the possible innate immune response associated with this disease under diabetes mellitus (DM) conditions
Summary
Post-contrast acute kidney injury (PC-AKI) refers to a decrease in renal function after intravascular administration of contrast medium (CM; iodinate based). The risk of PC-AKI has been considered overestimated in a series of meta-analyses (Kooiman et al, 2012; Moos et al, 2013), the condition still affects patients who receive CM, especially those who have impaired renal function or kidney disease, resulting in increased morbidity and mortality and in prolonged hospital stays (Kooiman et al, 2015; Mitchell et al, 2015). Diabetes mellitus (DM) is becoming a common disease threatening human health, and DM increases the risk of PC-AKI (Hoste et al, 2018; van der Molen et al, 2018b). We first test fMRI as a potential technique for CI-AKI assessment.
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
