Renal tissue oxygenation in children with chronic kidney disease due to vesicoureteral reflux

Hassib Chehade, Bastien Milani, Annalisa Ansaloni, Christiane Anex, Isabelle Bassi, Maciej Piskunowicz, Matthias Stuber, Francois Cachat, Michel Burnier, Menno Pruijm

Research output: Contribution to journalArticle

Abstract

Background: Vesicoureteral reflux (VUR) is a frequent cause of chronic kidney disease (CKD) in children. Using blood oxygenation level-dependent magnetic resonance imaging (BOLD-MRI), we measured cortical and medullary oxygenation in children with CKD due to VUR and compared the results to those obtained on healthy controls. Method: The study population comprised 37 children (19 with CKD due to VUR and 18 healthy age-matched controls). BOLD-MRI was performed before and after furosemide treatment. MR images were analyzed with the region-of-interest (ROI) technique to assess the mean R2* values (=1/T2*) of the cortex and medulla of each kidney and with the concentric object (CO) technique that divides renal parenchyma in 12 equal layers. Results: R2* values were significantly lower (corresponding to higher oxygenation) in the cortex and medulla of kidneys of children with CKD due to VUR than in those of the healthy controls (cortex 16.4 ± 1.4 vs. 17.2 ± 1.6 s−1, respectively; medulla 28.4 ± 3.2 vs. 30.3 ± 1.9 s−1, respectively; P <0.05), and furosemide-induced changes in medullary R2* were smaller in the former than in the latter (−5.7 ± 3.0 vs. −6.9 ± 3.4 s−1, respectively; P <0.05). Similar results were found with the CO technique. In children with a history of unilateral reflux (n = 9), the non-affected contralateral kidneys presented similar R2* values as the diseased kidneys, but their response to furosemide was significantly larger (−7.4 ± 3.2 vs. −5.7 ± 3.0, respectively; P = 0.05). Conclusions: Chronic kidney disease due to VUR is not associated with kidney tissue hypoxia in children. The significantly larger furosemide-induced decrease in medullary R2* levels in the healthy group and unaffected contralateral kidneys of the VUR group points towards more intense renal sodium transport in these kidneys.

Original languageEnglish (US)
Pages (from-to)1-9
Number of pages9
JournalPediatric Nephrology
DOIs
StateAccepted/In press - May 26 2016
Externally publishedYes

Fingerprint

Vesico-Ureteral Reflux
Chronic Renal Insufficiency
Furosemide
Kidney
Kidney Medulla
Magnetic Resonance Imaging
Kidney Cortex
Kidney Diseases
Sodium
Population

Keywords

  • BOLD-MRI
  • Children
  • Chronic kidney disease
  • Hypoxia
  • Oxygenation
  • Vesicoureteral reflux

ASJC Scopus subject areas

  • Nephrology
  • Pediatrics, Perinatology, and Child Health

Cite this

Chehade, H., Milani, B., Ansaloni, A., Anex, C., Bassi, I., Piskunowicz, M., ... Pruijm, M. (Accepted/In press). Renal tissue oxygenation in children with chronic kidney disease due to vesicoureteral reflux. Pediatric Nephrology, 1-9. https://doi.org/10.1007/s00467-016-3419-0

Renal tissue oxygenation in children with chronic kidney disease due to vesicoureteral reflux. / Chehade, Hassib; Milani, Bastien; Ansaloni, Annalisa; Anex, Christiane; Bassi, Isabelle; Piskunowicz, Maciej; Stuber, Matthias; Cachat, Francois; Burnier, Michel; Pruijm, Menno.

In: Pediatric Nephrology, 26.05.2016, p. 1-9.

Research output: Contribution to journalArticle

Chehade, H, Milani, B, Ansaloni, A, Anex, C, Bassi, I, Piskunowicz, M, Stuber, M, Cachat, F, Burnier, M & Pruijm, M 2016, 'Renal tissue oxygenation in children with chronic kidney disease due to vesicoureteral reflux', Pediatric Nephrology, pp. 1-9. https://doi.org/10.1007/s00467-016-3419-0
Chehade, Hassib ; Milani, Bastien ; Ansaloni, Annalisa ; Anex, Christiane ; Bassi, Isabelle ; Piskunowicz, Maciej ; Stuber, Matthias ; Cachat, Francois ; Burnier, Michel ; Pruijm, Menno. / Renal tissue oxygenation in children with chronic kidney disease due to vesicoureteral reflux. In: Pediatric Nephrology. 2016 ; pp. 1-9.
@article{5d8713f7ee0b4d68a8af23c675b0d851,
title = "Renal tissue oxygenation in children with chronic kidney disease due to vesicoureteral reflux",
abstract = "Background: Vesicoureteral reflux (VUR) is a frequent cause of chronic kidney disease (CKD) in children. Using blood oxygenation level-dependent magnetic resonance imaging (BOLD-MRI), we measured cortical and medullary oxygenation in children with CKD due to VUR and compared the results to those obtained on healthy controls. Method: The study population comprised 37 children (19 with CKD due to VUR and 18 healthy age-matched controls). BOLD-MRI was performed before and after furosemide treatment. MR images were analyzed with the region-of-interest (ROI) technique to assess the mean R2* values (=1/T2*) of the cortex and medulla of each kidney and with the concentric object (CO) technique that divides renal parenchyma in 12 equal layers. Results: R2* values were significantly lower (corresponding to higher oxygenation) in the cortex and medulla of kidneys of children with CKD due to VUR than in those of the healthy controls (cortex 16.4 ± 1.4 vs. 17.2 ± 1.6 s−1, respectively; medulla 28.4 ± 3.2 vs. 30.3 ± 1.9 s−1, respectively; P <0.05), and furosemide-induced changes in medullary R2* were smaller in the former than in the latter (−5.7 ± 3.0 vs. −6.9 ± 3.4 s−1, respectively; P <0.05). Similar results were found with the CO technique. In children with a history of unilateral reflux (n = 9), the non-affected contralateral kidneys presented similar R2* values as the diseased kidneys, but their response to furosemide was significantly larger (−7.4 ± 3.2 vs. −5.7 ± 3.0, respectively; P = 0.05). Conclusions: Chronic kidney disease due to VUR is not associated with kidney tissue hypoxia in children. The significantly larger furosemide-induced decrease in medullary R2* levels in the healthy group and unaffected contralateral kidneys of the VUR group points towards more intense renal sodium transport in these kidneys.",
keywords = "BOLD-MRI, Children, Chronic kidney disease, Hypoxia, Oxygenation, Vesicoureteral reflux",
author = "Hassib Chehade and Bastien Milani and Annalisa Ansaloni and Christiane Anex and Isabelle Bassi and Maciej Piskunowicz and Matthias Stuber and Francois Cachat and Michel Burnier and Menno Pruijm",
year = "2016",
month = "5",
day = "26",
doi = "10.1007/s00467-016-3419-0",
language = "English (US)",
pages = "1--9",
journal = "Pediatric Nephrology",
issn = "0931-041X",
publisher = "Springer Verlag",

}

TY - JOUR

T1 - Renal tissue oxygenation in children with chronic kidney disease due to vesicoureteral reflux

AU - Chehade, Hassib

AU - Milani, Bastien

AU - Ansaloni, Annalisa

AU - Anex, Christiane

AU - Bassi, Isabelle

AU - Piskunowicz, Maciej

AU - Stuber, Matthias

AU - Cachat, Francois

AU - Burnier, Michel

AU - Pruijm, Menno

PY - 2016/5/26

Y1 - 2016/5/26

N2 - Background: Vesicoureteral reflux (VUR) is a frequent cause of chronic kidney disease (CKD) in children. Using blood oxygenation level-dependent magnetic resonance imaging (BOLD-MRI), we measured cortical and medullary oxygenation in children with CKD due to VUR and compared the results to those obtained on healthy controls. Method: The study population comprised 37 children (19 with CKD due to VUR and 18 healthy age-matched controls). BOLD-MRI was performed before and after furosemide treatment. MR images were analyzed with the region-of-interest (ROI) technique to assess the mean R2* values (=1/T2*) of the cortex and medulla of each kidney and with the concentric object (CO) technique that divides renal parenchyma in 12 equal layers. Results: R2* values were significantly lower (corresponding to higher oxygenation) in the cortex and medulla of kidneys of children with CKD due to VUR than in those of the healthy controls (cortex 16.4 ± 1.4 vs. 17.2 ± 1.6 s−1, respectively; medulla 28.4 ± 3.2 vs. 30.3 ± 1.9 s−1, respectively; P <0.05), and furosemide-induced changes in medullary R2* were smaller in the former than in the latter (−5.7 ± 3.0 vs. −6.9 ± 3.4 s−1, respectively; P <0.05). Similar results were found with the CO technique. In children with a history of unilateral reflux (n = 9), the non-affected contralateral kidneys presented similar R2* values as the diseased kidneys, but their response to furosemide was significantly larger (−7.4 ± 3.2 vs. −5.7 ± 3.0, respectively; P = 0.05). Conclusions: Chronic kidney disease due to VUR is not associated with kidney tissue hypoxia in children. The significantly larger furosemide-induced decrease in medullary R2* levels in the healthy group and unaffected contralateral kidneys of the VUR group points towards more intense renal sodium transport in these kidneys.

AB - Background: Vesicoureteral reflux (VUR) is a frequent cause of chronic kidney disease (CKD) in children. Using blood oxygenation level-dependent magnetic resonance imaging (BOLD-MRI), we measured cortical and medullary oxygenation in children with CKD due to VUR and compared the results to those obtained on healthy controls. Method: The study population comprised 37 children (19 with CKD due to VUR and 18 healthy age-matched controls). BOLD-MRI was performed before and after furosemide treatment. MR images were analyzed with the region-of-interest (ROI) technique to assess the mean R2* values (=1/T2*) of the cortex and medulla of each kidney and with the concentric object (CO) technique that divides renal parenchyma in 12 equal layers. Results: R2* values were significantly lower (corresponding to higher oxygenation) in the cortex and medulla of kidneys of children with CKD due to VUR than in those of the healthy controls (cortex 16.4 ± 1.4 vs. 17.2 ± 1.6 s−1, respectively; medulla 28.4 ± 3.2 vs. 30.3 ± 1.9 s−1, respectively; P <0.05), and furosemide-induced changes in medullary R2* were smaller in the former than in the latter (−5.7 ± 3.0 vs. −6.9 ± 3.4 s−1, respectively; P <0.05). Similar results were found with the CO technique. In children with a history of unilateral reflux (n = 9), the non-affected contralateral kidneys presented similar R2* values as the diseased kidneys, but their response to furosemide was significantly larger (−7.4 ± 3.2 vs. −5.7 ± 3.0, respectively; P = 0.05). Conclusions: Chronic kidney disease due to VUR is not associated with kidney tissue hypoxia in children. The significantly larger furosemide-induced decrease in medullary R2* levels in the healthy group and unaffected contralateral kidneys of the VUR group points towards more intense renal sodium transport in these kidneys.

KW - BOLD-MRI

KW - Children

KW - Chronic kidney disease

KW - Hypoxia

KW - Oxygenation

KW - Vesicoureteral reflux

UR - http://www.scopus.com/inward/record.url?scp=84969921538&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84969921538&partnerID=8YFLogxK

U2 - 10.1007/s00467-016-3419-0

DO - 10.1007/s00467-016-3419-0

M3 - Article

SP - 1

EP - 9

JO - Pediatric Nephrology

JF - Pediatric Nephrology

SN - 0931-041X

ER -