The number of people affected by chronic kidney disease (CKD) is on the rise. This is partly attributed to the increasing number of diabetics and hypetensives. Currently it is estimated that over 15 million people have moderate CKD in the US. But only a fraction of these will progress and ultimately require transplantaion or dialysis services. Currently, there is not a good way of identifying subjects who will progress. Determining this has important implications in terms of patient management. So, there has recently been an increased interest in developing alternate markers to characterize CKD. We propose to test whether one or several MRI markers would be useful in identifying subjects at risk of progression. In this study, we will evaluate these measurements in a small number of subjects with moderate CKD. Three types of markers are being proposed, one is simple kidney size measurement. The second is to characterize the structural makeup of the kidney. Fibrosis is a consequence of CKD and is known to be a key determinant for the disease progression. We will use apparent diffusion coefficient measurement to evaluate the degree of fibrosis. It is also now becoming well accepted that kidneys become more hypoxic under diseased conditions and this actually may drive the processes responsible for development of fibrosis. We have pioneered in the use of BOLD MRI to evaluate intrarenal oxygenation and will test if it can identify subjects at risk of progression. We will also test arterial spin labeling method to evaluae relative renal perfusion. All the proposed methods do not require any exogenous contrast administration. If the project is successful, it may lead to one or more markers for identifying subjects at risk of progression and in turn may have a significant impact on patient management. Also, these markers could be useful in monitoring disease progression and interventions. This would be significant for drug development and testing novel interventional strategies both in animal models and in humans.

Public Health Relevance

Currently it is estimated that over 15 million people in the US have moderate level of chronic kidney disease, but only a fraction of these will progress and ultimately require transplantaion or dialysis services. Currently, there is not a good way of identifying subjects who will progress. This study is designed to test whether one or several MRI markers would be useful in identifying subjects at risk of progression. This will have significant impact on our understanding of the disease and the ability to evaluate novel interventions.

Agency
National Institute of Health (NIH)
Institute
National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)
Type
Research Project (R01)
Project #
1R01DK093793-01A1
Application #
8371311
Study Section
Medical Imaging Study Section (MEDI)
Program Officer
Flessner, Michael Francis
Project Start
2012-07-10
Project End
2017-06-30
Budget Start
2012-07-10
Budget End
2013-06-30
Support Year
1
Fiscal Year
2012
Total Cost
$492,368
Indirect Cost
$155,897
Name
Northshore University Healthsystem
Department
Type
DUNS #
069490621
City
Evanston
State
IL
Country
United States
Zip Code
60201
Li, Lu-Ping; Thacker, Jon; Li, Wei et al. (2018) Consistency of Multiple Renal Functional MRI Measurements Over 18 Months. J Magn Reson Imaging 48:514-521
Prasad, Pottumarthi V (2018) Update on renal blood oxygenation level-dependent MRI to assess intrarenal oxygenation in chronic kidney disease. Kidney Int 93:778-780
Pruijm, Menno; Mendichovszky, Iosif A; Liss, Per et al. (2018) Renal blood oxygenation level-dependent magnetic resonance imaging to measure renal tissue oxygenation: a statement paper and systematic review. Nephrol Dial Transplant 33:ii22-ii28
Prasad, Pottumarthi V; Li, Wei; Raj, Dominic S et al. (2018) Multicenter Study Evaluating Intrarenal Oxygenation and Fibrosis Using Magnetic Resonance Imaging in Individuals With Advanced CKD. Kidney Int Rep 3:1467-1472
Li, Lu-Ping; Tan, Huan; Thacker, Jon M et al. (2017) Evaluation of Renal Blood Flow in Chronic Kidney Disease Using Arterial Spin Labeling Perfusion Magnetic Resonance Imaging. Kidney Int Rep 2:36-43
Thacker, Jon; Zhang, Jeff L; Franklin, Tammy et al. (2017) BOLD quantified renal pO2 is sensitive to pharmacological challenges in rats. Magn Reson Med 78:297-302
Prasad, Pottumarthi V; Thacker, Jon; Li, Lu-Ping et al. (2015) Multi-Parametric Evaluation of Chronic Kidney Disease by MRI: A Preliminary Cross-Sectional Study. PLoS One 10:e0139661
Thacker, Jon M; Li, Lu-Ping; Li, Wei et al. (2015) Renal Blood Oxygenation Level-Dependent Magnetic Resonance Imaging: A Sensitive and Objective Analysis. Invest Radiol 50:821-7
Tan, Huan; Koktzoglou, Ioannis; Prasad, Pottumarthi V (2014) Renal perfusion imaging with two-dimensional navigator gated arterial spin labeling. Magn Reson Med 71:570-9