Can COMBINED Magnetic Resonance Imaging Measure the Progression of Kidney Disease?
| Autor: | Menno Pruijm |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
Male
Niacinamide Oncology medicine.medical_specialty Epidemiology Population 030232 urology & nephrology 030204 cardiovascular system & hematology Kidney urologic and male genital diseases Critical Care and Intensive Care Medicine 03 medical and health sciences 0302 clinical medicine Lanthanum Internal medicine medicine Humans Renal Insufficiency Chronic education Aged Transplantation education.field_of_study medicine.diagnostic_test business.industry Disease progression Editorials Magnetic resonance imaging Original Articles Middle Aged medicine.disease Magnetic Resonance Imaging Fibrosis female genital diseases and pregnancy complications ErbB Receptors Diffusion Magnetic Resonance Imaging medicine.anatomical_structure Nephrology Vitamin B Complex Biomarker (medicine) Drug Therapy Combination Female business Glomerular Filtration Rate Kidney disease |
| Zdroj: | Clin J Am Soc Nephrol |
| ISSN: | 1555-905X 1555-9041 |
| Popis: | BACKGROUND AND OBJECTIVES: Kidney functional magnetic resonance imaging (MRI) requires further investigation to enhance the noninvasive identification of patients at high risk of CKD progression. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: In this exploratory study, we obtained baseline diffusion-weighted and blood oxygen level–dependent MRI in 122 participants of the CKD Optimal Management with Binders and Nicotinamide trial, which was a multicenter, randomized, double-blinded, 12-month, four-group parallel trial of nicotinamide and lanthanum carbonate versus placebo conducted in individuals with eGFR 20–45 ml/min per 1.73 m(2). Lower values of apparent diffusion coefficient (ADC) on diffusion-weighted MRI may indicate increased fibrosis, and higher values of relaxation rate (R2*) on blood oxygen level–dependent MRI may represent decreased oxygenation. Because there was no effect of active treatment on eGFR over 12 months, we tested whether baseline kidney functional MRI biomarkers were associated with eGFR decline in all 122 participants. In a subset of 87 participants with 12-month follow-up MRI data, we evaluated whether kidney functional MRI biomarkers change over time. RESULTS: Mean baseline eGFR was 32±9 ml/min per 1.73 m(2), and mean annual eGFR slope was −2.3 (95% confidence interval [95% CI], −3.4 to −1.1) ml/min per 1.73 m(2) per year. After adjustment for baseline covariates, baseline ADC was associated with change in eGFR over time (difference in annual eGFR slope per 1 SD increase in ADC: 1.3 [95% CI, 0.1 to 2.5] ml/min per 1.73 m(2) per year, ADC×time interaction P=0.04). This association was no longer significant after further adjustment for albuminuria (difference in annual eGFR slope per 1 SD increase in ADC: 1.0 (95% CI, −0.1 to 2.2) ml/min per 1.73 m(2) per year, ADC×time interaction P=0.08). There was no significant association between baseline R2* and change in eGFR over time. In 87 participants with follow-up functional MRI, ADC and R2* values remained stable over 12 months (intraclass correlation: 0.71 and 0.68, respectively). CONCLUSIONS: Baseline cortical ADC was associated with change in eGFR over time, but this association was not independent of albuminuria. Kidney functional MRI biomarkers remained stable over 1 year. CLINICAL TRIAL REGISTRY NAME AND REGISTRATION NUMBER: CKD Optimal Management with Binders and Nicotinamide (COMBINE), NCT02258074. |
| Databáze: | OpenAIRE |
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