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Wang X, Cao YY, Jiang Y, Jia M, Tian G, Bu CQ, Zhao N, Yue XZ, Shen ZW, Ji Y, Han YD. Effects of Breathing Patterns on Amide Proton Transfer MRI in the Kidney: A Preliminary Comparative Study in Healthy Volunteers and Patients With Tumors. J Magn Reson Imaging 2024; 60:222-230. [PMID: 37888865 DOI: 10.1002/jmri.29099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Revised: 10/16/2023] [Accepted: 10/16/2023] [Indexed: 10/28/2023] Open
Abstract
BACKGROUND The amide proton transfer-weighted (APTw) imaging for kidney diseases is important. However, the breathing patterns on APTw imaging remains unexplored. PURPOSE This study aimed to investigate the effects of intermittent breath-hold (IBH) and free breathing (FB) on renal 3D-APTw imaging. STUDY TYPE Healthy volunteers were enrolled prospectively, and renal clear cell carcinoma (RCCC) patients were included retrospectively. POPULATION 58 healthy volunteers and 10 RCCC patients. FIELD STRENGTH/SEQUENCE 3-T, turbo spin echo, and fast field echo. ASSESSMENT 3D-APTw imaging was scanned using the IBH and FB methods in volunteers and using the IBH method in RCCC patients. The image quality was evaluated by three observers according to the 5-point Likert scale. Optimal images rated at three points or higher were used to measure the APT values. STATISTICAL ANALYSIS The measurement repeatability was assessed using the intraclass correlation coefficient (ICC) and the Bland-Altman plot. The APT values were analyzed using McNemar's test, one-way analysis of variance, and t test. RESULTS 50 healthy volunteers and 8 RCCC patients were enrolled. Renal 3D-APTw imaging using the IBH method revealed a higher success rate (88% vs 78%). The ICCs were excellent in the IBH group (ICCs > 0.74) and were good in the FB group (ICCs < 0.74). No significant differences in the APT values among various zones using the IBH (P = 0.263) or FB method (P = 0.506). The mean APT value using the IBH method (2.091% ± 0.388%) was slightly lower than the FB method (2.176% ± 0.292%), but no significant difference (P = 0.233). The APT value of RCCC (4.832% ± 1.361%) was considerably higher than normal renal using the IBH method. CONCLUSIONS The study demonstrated that the IBH method substantially increased the image quality of renal 3D-APTw imaging. Furthermore, APT values may vary between normal and tumor tissues. LEVEL OF EVIDENCE 2 TECHNICAL EFFICACY: Stage 2.
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Affiliation(s)
- X Wang
- Department of Radiology, Xi'an GaoXin Hospital, Xi'an Jiao Tong University, Xi'an, Shaanxi, China
| | - Y Y Cao
- Department of Imaging Center, First Affiliated Hospital, Xi'an Medical University, Xi'an, Shaanxi, China
| | - Y Jiang
- Department of Radiology, Xi'an GaoXin Hospital, Xi'an Jiao Tong University, Xi'an, Shaanxi, China
| | - M Jia
- Department of Radiology, Xi'an GaoXin Hospital, Xi'an Jiao Tong University, Xi'an, Shaanxi, China
| | - G Tian
- Department of Radiology, Xi'an GaoXin Hospital, Xi'an Jiao Tong University, Xi'an, Shaanxi, China
| | - C Q Bu
- Department of Radiology, Xi'an GaoXin Hospital, Xi'an Jiao Tong University, Xi'an, Shaanxi, China
| | - N Zhao
- Department of Radiology, Xi'an GaoXin Hospital, Xi'an Jiao Tong University, Xi'an, Shaanxi, China
| | - X Z Yue
- Philips Healthcare, Beijing, China
| | - Z W Shen
- Philips Healthcare, Beijing, China
| | - Y Ji
- Department of Imaging Center, First Affiliated Hospital, Xi'an Medical University, Xi'an, Shaanxi, China
| | - Y D Han
- Department of Radiology, Xi'an GaoXin Hospital, Xi'an Jiao Tong University, Xi'an, Shaanxi, China
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2
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Bane O, Mendichovszky IA, Milani B, Dekkers IA, Deux JF, Eckerbom P, Grenier N, Hall ME, Inoue T, Laustsen C, Lerman LO, Liu C, Morrell G, Pedersen M, Pruijm M, Sadowski EA, Seeliger E, Sharma K, Thoeny H, Vermathen P, Wang ZJ, Serafin Z, Zhang JL, Francis ST, Sourbron S, Pohlmann A, Fain SB, Prasad PV. Consensus-based technical recommendations for clinical translation of renal BOLD MRI. MAGMA (NEW YORK, N.Y.) 2020; 33:199-215. [PMID: 31768797 PMCID: PMC7021747 DOI: 10.1007/s10334-019-00802-x] [Citation(s) in RCA: 42] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/05/2019] [Revised: 10/18/2019] [Accepted: 10/22/2019] [Indexed: 01/08/2023]
Abstract
Harmonization of acquisition and analysis protocols is an important step in the validation of BOLD MRI as a renal biomarker. This harmonization initiative provides technical recommendations based on a consensus report with the aim to move towards standardized protocols that facilitate clinical translation and comparison of data across sites. We used a recently published systematic review paper, which included a detailed summary of renal BOLD MRI technical parameters and areas of investigation in its supplementary material, as the starting point in developing the survey questionnaires for seeking consensus. Survey data were collected via the Delphi consensus process from 24 researchers on renal BOLD MRI exam preparation, data acquisition, data analysis, and interpretation. Consensus was defined as ≥ 75% unanimity in response. Among 31 survey questions, 14 achieved consensus resolution, 12 showed clear respondent preference (65-74% agreement), and 5 showed equal (50/50%) split in opinion among respondents. Recommendations for subject preparation, data acquisition, processing and reporting are given based on the survey results and review of the literature. These technical recommendations are aimed towards increased inter-site harmonization, a first step towards standardization of renal BOLD MRI protocols across sites. We expect this to be an iterative process updated dynamically based on progress in the field.
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Affiliation(s)
- Octavia Bane
- BioMedical Engineering and Imaging Institute and Department of Radiology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Iosif A Mendichovszky
- Department of Radiology, Cambridge University Hospitals NHS Foundation Trust, Cambridge University Hospitals NHS Foundation Trust, Addenbrooke's Hospital, Cambridge, UK
| | - Bastien Milani
- Center for BioMedical Imaging, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Ilona A Dekkers
- Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Jean-Francois Deux
- Department of Radiology, Groupe Hospitalier Henri Mondor, Créteil, France
| | - Per Eckerbom
- Department of Radiology, Institution for Surgical Sciences, Uppsala University, Uppsala, Sweden
| | - Nicolas Grenier
- Department of Radiology, Université de Bordeaux, CHU de Bordeaux, Bordeaux, France
| | - Michael E Hall
- Department of Medicine, University of Mississippi Medical Center, Jackson, MS, USA
| | - Tsutomu Inoue
- Department of Nephrology, Faculty of Medicine, Saitama Medical University, Saitama, Japan
| | - Christoffer Laustsen
- The MR Research Center Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Lilach O Lerman
- Division of Nephrology and Hypertension, Department of Internal Medicine, Mayo Clinic, Rochester, MN, USA
| | - Chunlei Liu
- Electrical Engineering and Computer Science, and Helen Wills Neuroscience Institute, University of California Berkeley, Berkeley, CA, USA
| | - Glen Morrell
- Department of Radiology and Imaging Sciences, University of Utah, Salt Lake City, UT, USA
| | - Michael Pedersen
- Department of Clinical Medicine-Comparative Medicine Lab, Aarhus University Hospital, Aarhus, Denmark
| | - Menno Pruijm
- Nephrology and Hypertension Service, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Elizabeth A Sadowski
- Department of Radiology, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - Erdmann Seeliger
- Institute of Physiology, Charité-University Medicine Berlin, Berlin, Germany
| | - Kanishka Sharma
- Imaging Biomarkers Group, Department of Biomedical Imaging Sciences, University of Leeds, Leeds, UK
| | - Harriet Thoeny
- Department of Radiology, Hôpital Cantonal Fribourgois, University of Fribourg, Fribourg, Switzerland
| | - Peter Vermathen
- Departments for BioMedical Research and Radiology, Inselspital, Universitaetspital Bern, Bern, Switzerland
| | - Zhen J Wang
- Department of Radiology and Biomedical Imaging, University of California San Francisco Medical Center, San Francisco, CA, USA
| | - Zbigniew Serafin
- Department of Radiology, Nicolaus Copernicus University, Collegium Medicum, Bydgoszcz, Poland
| | - Jeff L Zhang
- Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Susan T Francis
- Sir Peter Mansfield Centre, University of Notthingham, Notthingham, UK
| | - Steven Sourbron
- Imaging Biomarkers Group, Department of Biomedical Imaging Sciences, University of Leeds, Leeds, UK
| | - Andreas Pohlmann
- Berlin Ultrahigh Field Facility, Max Delbrueck Center for Molecular Medicine in the Helmholtz Association, Berlin, Germany
| | - Sean B Fain
- Departments of Biomedical Engineering, Radiology, and Medical Physics, University of Wisconsin, Madison, WI, USA
| | - Pottumarthi V Prasad
- Department of Radiology, Center for Advanced Imaging, NorthShore University Health System, Evanston, IL, USA.
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3
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Bane O, Mendichovszky IA, Milani B, Dekkers IA, Deux JF, Eckerbom P, Grenier N, Hall ME, Inoue T, Laustsen C, Lerman LO, Liu C, Morrell G, Pedersen M, Pruijm M, Sadowski EA, Seeliger E, Sharma K, Thoeny H, Vermathen P, Wang ZJ, Serafin Z, Zhang JL, Francis ST, Sourbron S, Pohlmann A, Fain SB, Prasad PV. Consensus-based technical recommendations for clinical translation of renal BOLD MRI. MAGMA (NEW YORK, N.Y.) 2019. [PMID: 31768797 DOI: 10.1007/s10334‐019‐00802‐x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Harmonization of acquisition and analysis protocols is an important step in the validation of BOLD MRI as a renal biomarker. This harmonization initiative provides technical recommendations based on a consensus report with the aim to move towards standardized protocols that facilitate clinical translation and comparison of data across sites. We used a recently published systematic review paper, which included a detailed summary of renal BOLD MRI technical parameters and areas of investigation in its supplementary material, as the starting point in developing the survey questionnaires for seeking consensus. Survey data were collected via the Delphi consensus process from 24 researchers on renal BOLD MRI exam preparation, data acquisition, data analysis, and interpretation. Consensus was defined as ≥ 75% unanimity in response. Among 31 survey questions, 14 achieved consensus resolution, 12 showed clear respondent preference (65-74% agreement), and 5 showed equal (50/50%) split in opinion among respondents. Recommendations for subject preparation, data acquisition, processing and reporting are given based on the survey results and review of the literature. These technical recommendations are aimed towards increased inter-site harmonization, a first step towards standardization of renal BOLD MRI protocols across sites. We expect this to be an iterative process updated dynamically based on progress in the field.
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Affiliation(s)
- Octavia Bane
- BioMedical Engineering and Imaging Institute and Department of Radiology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Iosif A Mendichovszky
- Department of Radiology, Cambridge University Hospitals NHS Foundation Trust, Cambridge University Hospitals NHS Foundation Trust, Addenbrooke's Hospital, Cambridge, UK
| | - Bastien Milani
- Center for BioMedical Imaging, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Ilona A Dekkers
- Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Jean-Francois Deux
- Department of Radiology, Groupe Hospitalier Henri Mondor, Créteil, France
| | - Per Eckerbom
- Department of Radiology, Institution for Surgical Sciences, Uppsala University, Uppsala, Sweden
| | - Nicolas Grenier
- Department of Radiology, Université de Bordeaux, CHU de Bordeaux, Bordeaux, France
| | - Michael E Hall
- Department of Medicine, University of Mississippi Medical Center, Jackson, MS, USA
| | - Tsutomu Inoue
- Department of Nephrology, Faculty of Medicine, Saitama Medical University, Saitama, Japan
| | - Christoffer Laustsen
- The MR Research Center Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Lilach O Lerman
- Division of Nephrology and Hypertension, Department of Internal Medicine, Mayo Clinic, Rochester, MN, USA
| | - Chunlei Liu
- Electrical Engineering and Computer Science, and Helen Wills Neuroscience Institute, University of California Berkeley, Berkeley, CA, USA
| | - Glen Morrell
- Department of Radiology and Imaging Sciences, University of Utah, Salt Lake City, UT, USA
| | - Michael Pedersen
- Department of Clinical Medicine-Comparative Medicine Lab, Aarhus University Hospital, Aarhus, Denmark
| | - Menno Pruijm
- Nephrology and Hypertension Service, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Elizabeth A Sadowski
- Department of Radiology, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - Erdmann Seeliger
- Institute of Physiology, Charité-University Medicine Berlin, Berlin, Germany
| | - Kanishka Sharma
- Imaging Biomarkers Group, Department of Biomedical Imaging Sciences, University of Leeds, Leeds, UK
| | - Harriet Thoeny
- Department of Radiology, Hôpital Cantonal Fribourgois, University of Fribourg, Fribourg, Switzerland
| | - Peter Vermathen
- Departments for BioMedical Research and Radiology, Inselspital, Universitaetspital Bern, Bern, Switzerland
| | - Zhen J Wang
- Department of Radiology and Biomedical Imaging, University of California San Francisco Medical Center, San Francisco, CA, USA
| | - Zbigniew Serafin
- Department of Radiology, Nicolaus Copernicus University, Collegium Medicum, Bydgoszcz, Poland
| | - Jeff L Zhang
- Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Susan T Francis
- Sir Peter Mansfield Centre, University of Notthingham, Notthingham, UK
| | - Steven Sourbron
- Imaging Biomarkers Group, Department of Biomedical Imaging Sciences, University of Leeds, Leeds, UK
| | - Andreas Pohlmann
- Berlin Ultrahigh Field Facility, Max Delbrueck Center for Molecular Medicine in the Helmholtz Association, Berlin, Germany
| | - Sean B Fain
- Departments of Biomedical Engineering, Radiology, and Medical Physics, University of Wisconsin, Madison, WI, USA
| | - Pottumarthi V Prasad
- Department of Radiology, Center for Advanced Imaging, NorthShore University Health System, Evanston, IL, USA.
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4
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van der Bel R, Verbree J, Gurney-Champion OJ, van Osch MJP, Stroes ESG, Nederveen AJ, Krediet CTP. Sympathetic activation by lower body negative pressure decreases kidney perfusion without inducing hypoxia in healthy humans. Clin Auton Res 2018; 30:149-156. [PMID: 30390156 PMCID: PMC7113195 DOI: 10.1007/s10286-018-0570-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2018] [Accepted: 10/10/2018] [Indexed: 12/25/2022]
Abstract
Purpose There is ample evidence that systemic sympathetic neural activity contributes to the progression of chronic kidney disease, possibly by limiting renal blood flow and thereby inducing renal hypoxia. Up to now there have been no direct observations of this mechanism in humans. We studied the effects of systemic sympathetic activation elicited by a lower body negative pressure (LBNP) on renal blood flow (RBF) and renal oxygenation in healthy humans. Methods Eight healthy volunteers (age 19–31 years) were subjected to progressive LBNP at − 15 and − 30 mmHg, 15 min per level. Brachial artery blood pressure was monitored intermittently. RBF was measured by phase-contrast MRI in the proximal renal artery. Renal vascular resistance was calculated as the MAP divided by the RBF. Renal oxygenation (R2*) was measured for the cortex and medulla by blood oxygen level dependent (BOLD) MRI, using a monoexponential fit. Results With a LBNP of − 30 mmHg, pulse pressure decreased from 50 ± 10 to 43 ± 7 mmHg; MAP did not change. RBF decreased from 1152 ± 80 to 1038 ± 83 mL/min to 950 ± 67 mL/min at − 30 mmHg LBNP (p = 0.013). Heart rate and renal vascular resistance increased by 38 ± 15% and 23 ± 8% (p = 0.04) at − 30 mmHg LBNP, respectively. There was no change in cortical or medullary R2* (20.3 ± 1.2 s−1 vs 19.8 ± 0.43 s−1; 28.6 ± 1.1 s−1 vs 28.0 ± 1.3 s−1). Conclusion The results suggest that an increase in sympathetic vasoconstrictor drive decreases kidney perfusion without a parallel reduction in oxygenation in healthy humans. This in turn indicates that sympathetic activation suppresses renal oxygen demand and supply equally, thus allowing adequate tissue oxygenation to be maintained.
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Affiliation(s)
- René van der Bel
- Department of Internal Medicine, Academic Medical Center at the University of Amsterdam, Meibergdreef 9, 1105AZ, Amsterdam, The Netherlands
| | - Jasper Verbree
- Department of Radiology, C.J. Gorter Center for High Field MRI, Leiden University Medical Center, Leiden, The Netherlands
| | - Oliver J Gurney-Champion
- Department of Radiology, Academic Medical Center at the University of Amsterdam, Amsterdam, The Netherlands.,Department of Radiation Oncology, Academic Medical Center at the University of Amsterdam, Amsterdam, The Netherlands
| | - Matthias J P van Osch
- Department of Radiology, C.J. Gorter Center for High Field MRI, Leiden University Medical Center, Leiden, The Netherlands
| | - Erik S G Stroes
- Department of Internal Medicine, Academic Medical Center at the University of Amsterdam, Meibergdreef 9, 1105AZ, Amsterdam, The Netherlands
| | - Aart J Nederveen
- Department of Radiology, Academic Medical Center at the University of Amsterdam, Amsterdam, The Netherlands
| | - C T Paul Krediet
- Department of Internal Medicine, Academic Medical Center at the University of Amsterdam, Meibergdreef 9, 1105AZ, Amsterdam, The Netherlands.
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5
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Zhou JY, Wang YC, Zeng CH, Ju SH. Renal Functional MRI and Its Application. J Magn Reson Imaging 2018; 48:863-881. [PMID: 30102436 DOI: 10.1002/jmri.26180] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2018] [Accepted: 04/10/2018] [Indexed: 12/11/2022] Open
Abstract
Renal function varies according to the nature and stage of diseases. Renal functional magnetic resonance imaging (fMRI), a technique considered superior to the most common method used to estimate the glomerular filtration rate, allows for noninvasive, accurate measurements of renal structures and functions in both animals and humans. It has become increasingly prevalent in research and clinical applications. In recent years, renal fMRI has developed rapidly with progress in MRI hardware and emerging postprocessing algorithms. Function-related imaging markers can be acquired via renal fMRI, encompassing water molecular diffusion, perfusion, and oxygenation. This review focuses on the progression and challenges of the main renal fMRI methods, including dynamic contrast-enhanced MRI, blood oxygen level-dependent MRI, diffusion-weighted imaging, diffusion tensor imaging, arterial spin labeling, fat fraction imaging, and their recent clinical applications. LEVEL OF EVIDENCE 5 Technical Efficacy: Stage 2 J. Magn. Reson. Imaging 2018;48:863-881.
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Affiliation(s)
- Jia-Ying Zhou
- Jiangsu Key Laboratory of Molecular and Functional Imaging, Department of Radiology, Zhongda Hospital, Medical School, Southeast University, Nanjing, China
| | - Yuan-Cheng Wang
- Jiangsu Key Laboratory of Molecular and Functional Imaging, Department of Radiology, Zhongda Hospital, Medical School, Southeast University, Nanjing, China
| | - Chu-Hui Zeng
- Jiangsu Key Laboratory of Molecular and Functional Imaging, Department of Radiology, Zhongda Hospital, Medical School, Southeast University, Nanjing, China
| | - Sheng-Hong Ju
- Jiangsu Key Laboratory of Molecular and Functional Imaging, Department of Radiology, Zhongda Hospital, Medical School, Southeast University, Nanjing, China
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6
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Hall ME, Jordan JH, Juncos LA, Hundley WG, Hall JE. BOLD magnetic resonance imaging in nephrology. Int J Nephrol Renovasc Dis 2018; 11:103-112. [PMID: 29559807 PMCID: PMC5856054 DOI: 10.2147/ijnrd.s112299] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Magnetic resonance (MR) imaging, a non-invasive modality that provides anatomic and physiologic information, is increasingly used for diagnosis of pathophysiologic conditions and for understanding renal physiology in humans. Although functional MR imaging methods were pioneered to investigate the brain, they also offer powerful techniques for investigation of other organ systems such as the kidneys. However, imaging the kidneys provides unique challenges due to potential complications from contrast agents. Therefore, development of non-contrast techniques to study kidney anatomy and physiology is important. Blood oxygen level-dependent (BOLD) MR is a non-contrast imaging technique that provides functional information related to renal tissue oxygenation in various pathophysiologic conditions. Here we discuss technical considerations, clinical uses and future directions for use of BOLD MR as well as complementary MR techniques to better understand renal pathophysiology. Our intent is to summarize kidney BOLD MR applications for the clinician rather than focusing on the complex physical challenges that functional MR imaging encompasses; however, we briefly discuss some of those issues.
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Affiliation(s)
- Michael E Hall
- Department of Medicine, University of Mississippi Medical Center, Jackson, MS, USA.,Department of Physiology and Biophysics, University of Mississippi Medical Center, Jackson, MS, USA
| | - Jennifer H Jordan
- Department of Internal Medicine, Section on Cardiovascular Medicine, Wake Forest University School of Medicine, Winston-Salem, NC, USA
| | - Luis A Juncos
- Department of Medicine, University of Mississippi Medical Center, Jackson, MS, USA.,Department of Physiology and Biophysics, University of Mississippi Medical Center, Jackson, MS, USA
| | - W Gregory Hundley
- Department of Internal Medicine, Section on Cardiovascular Medicine, Wake Forest University School of Medicine, Winston-Salem, NC, USA
| | - John E Hall
- Department of Physiology and Biophysics, University of Mississippi Medical Center, Jackson, MS, USA
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7
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van der Bel R, Coolen BF, Nederveen AJ, Potters WV, Verberne HJ, Vogt L, Stroes ESG, Krediet CTP. Magnetic Resonance Imaging-Derived Renal Oxygenation and Perfusion During Continuous, Steady-State Angiotensin-II Infusion in Healthy Humans. J Am Heart Assoc 2016; 5:e003185. [PMID: 27021686 PMCID: PMC4943284 DOI: 10.1161/jaha.115.003185] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
Background The role of kidney hypoxia is considered pivotal in the progression of chronic kidney disease. A widely used method to assess kidney oxygenation is blood oxygen level dependent (BOLD)–magnetic resonance imaging (MRI), but its interpretation remains problematic. The BOLD‐MRI signal is the result of kidney oxygen consumption (a proxy of glomerular filtration) and supply (ie, glomerular perfusion). Therefore, we hypothesized that with pharmacological modulation of kidney blood flow, renal oxygenation, as assessed by BOLD‐MRI, correlates to filtration fraction (ie, glomerular filtration rate/effective renal plasma flow) in healthy humans. Methods and Results Eight healthy volunteers were subjected to continuous angiotensin‐II infusion at 0.3, 0.9, and 3.0 ng/kg per minute. At each dose, renal oxygenation and blood flow were assessed using BOLD and phase‐contrast MRI. Subsequently, “gold standard” glomerular filtration rate/effective renal plasma flow measurements were performed under the same conditions. Renal plasma flow decreased dose dependently from 660±146 to 467±103 mL/min per 1.73 m2 (F[3, 21]=33.3, P<0.001). Glomerular filtration rate decreased from 121±23 to 110±18 mL/min per 1.73 m2 (F[1.8, 2.4]=6.4, P=0.013). Cortical transverse relaxation rate (R2*; increases in R2* represent decreases in oxygenation) increased by 7.2±3.8% (F[3, 21]=7.37, P=0.001); medullar R2* did not change. Cortical R2* related to filtration fraction (R2 0.46, P<0.001). Conclusions By direct comparison between “gold standard” kidney function measurements and BOLD MRI, we showed that cortical oxygenation measured by BOLD MRI relates poorly to glomerular filtration rate but is associated with filtration fraction. For future studies, there may be a need to include renal plasma flow measurements when employing renal BOLD‐MRI.
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Affiliation(s)
- René van der Bel
- Department of Internal Medicine, Academic Medical Center at the University of Amsterdam, The Netherlands
| | - Bram F Coolen
- Department of Radiology, Academic Medical Center at the University of Amsterdam, The Netherlands
| | - Aart J Nederveen
- Department of Radiology, Academic Medical Center at the University of Amsterdam, The Netherlands
| | - Wouter V Potters
- Department of Radiology, Academic Medical Center at the University of Amsterdam, The Netherlands
| | - Hein J Verberne
- Department of Nuclear Medicine, Academic Medical Center at the University of Amsterdam, The Netherlands
| | - Liffert Vogt
- Department of Internal Medicine, Academic Medical Center at the University of Amsterdam, The Netherlands
| | - Erik S G Stroes
- Department of Internal Medicine, Academic Medical Center at the University of Amsterdam, The Netherlands
| | - C T Paul Krediet
- Department of Internal Medicine, Academic Medical Center at the University of Amsterdam, The Netherlands
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8
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Cantow K, Arakelyan K, Seeliger E, Niendorf T, Pohlmann A. Assessment of Renal Hemodynamics and Oxygenation by Simultaneous Magnetic Resonance Imaging (MRI) and Quantitative Invasive Physiological Measurements. Methods Mol Biol 2016; 1397:129-154. [PMID: 26676132 DOI: 10.1007/978-1-4939-3353-2_11] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
In vivo assessment of renal perfusion and oxygenation under (patho)physiological conditions by means of noninvasive diagnostic imaging is conceptually appealing. Blood oxygen level-dependent (BOLD) magnetic resonance imaging (MRI) and quantitative parametric mapping of the magnetic resonance (MR) relaxation times T 2* and T 2 are thought to provide surrogates of renal tissue oxygenation. The validity and efficacy of this technique for quantitative characterization of local tissue oxygenation and its changes under different functional conditions have not been systematically examined yet and remain to be established. For this purpose, the development of an integrative multimodality approaches is essential. Here we describe an integrated hybrid approach (MR-PHYSIOL) that combines established quantitative physiological measurements with T 2* (T 2) mapping and MR-based kidney size measurements. Standardized reversible (patho)physiologically relevant interventions, such as brief periods of aortic occlusion, hypoxia, and hyperoxia, are used for detailing the relation between the MR-PHYSIOL parameters, in particular between renal T 2* and tissue oxygenation.
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Affiliation(s)
- Kathleen Cantow
- Institute of Physiology, Charité-Universitätsmedizin Berlin, Campus Mitte, Berlin, Germany
- Center for Cardiovascular Research, Berlin, Germany
| | - Karen Arakelyan
- Institute of Physiology, Charité-Universitätsmedizin Berlin, Campus Mitte, Berlin, Germany
- Center for Cardiovascular Research, Berlin, Germany
| | - Erdmann Seeliger
- Institute of Physiology, Charité-Universitätsmedizin Berlin, Campus Mitte, Berlin, Germany
- Center for Cardiovascular Research, Berlin, Germany
| | - Thoralf Niendorf
- Berlin Ultrahigh Field Facility (B.U.F.F.), Max Delbrück Center for Molecular Medicine (MDC), Berlin, Germany
| | - Andreas Pohlmann
- Berlin Ultrahigh Field Facility (B.U.F.F.), Max Delbrück Center for Molecular Medicine (MDC), Berlin, Germany.
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9
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Detailing the relation between renal T2* and renal tissue pO2 using an integrated approach of parametric magnetic resonance imaging and invasive physiological measurements. Invest Radiol 2015; 49:547-60. [PMID: 24651661 DOI: 10.1097/rli.0000000000000054] [Citation(s) in RCA: 60] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVES This study was designed to detail the relation between renal T2* and renal tissue pO2 using an integrated approach that combines parametric magnetic resonance imaging (MRI) and quantitative physiological measurements (MR-PHYSIOL). MATERIALS AND METHODS Experiments were performed in 21 male Wistar rats. In vivo modulation of renal hemodynamics and oxygenation was achieved by brief periods of aortic occlusion, hypoxia, and hyperoxia. Renal perfusion pressure (RPP), renal blood flow (RBF), local cortical and medullary tissue pO2, and blood flux were simultaneously recorded together with T2*, T2 mapping, and magnetic resonance-based kidney size measurements (MR-PHYSIOL). Magnetic resonance imaging was carried out on a 9.4-T small-animal magnetic resonance system. Relative changes in the invasive quantitative parameters were correlated with relative changes in the parameters derived from MRI using Spearman analysis and Pearson analysis. RESULTS Changes in T2* qualitatively reflected tissue pO2 changes induced by the interventions. T2* versus pO2 Spearman rank correlations were significant for all interventions, yet quantitative translation of T2*/pO2 correlations obtained for one intervention to another intervention proved not appropriate. The closest T2*/pO2 correlation was found for hypoxia and recovery. The interlayer comparison revealed closest T2*/pO2 correlations for the outer medulla and showed that extrapolation of results obtained for one renal layer to other renal layers must be made with due caution. For T2* to RBF relation, significant Spearman correlations were deduced for all renal layers and for all interventions. T2*/RBF correlations for the cortex and outer medulla were even superior to those between T2* and tissue pO2. The closest T2*/RBF correlation occurred during hypoxia and recovery. Close correlations were observed between T2* and kidney size during hypoxia and recovery and for occlusion and recovery. In both cases, kidney size correlated well with renal vascular conductance, as did renal vascular conductance with T2*. Our findings indicate that changes in T2* qualitatively mirror changes in renal tissue pO2 but are also associated with confounding factors including vascular volume fraction and tubular volume fraction. CONCLUSIONS Our results demonstrate that MR-PHYSIOL is instrumental to detail the link between renal tissue pO2 and T2* in vivo. Unravelling the link between regional renal T2* and tissue pO2, including the role of the T2* confounding parameters vascular and tubular volume fraction and oxy-hemoglobin dissociation curve, requires further research. These explorations are essential before the quantitative capabilities of parametric MRI can be translated from experimental research to improved clinical understanding of hemodynamics/oxygenation in kidney disorders.
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Niendorf T, Pohlmann A, Arakelyan K, Flemming B, Cantow K, Hentschel J, Grosenick D, Ladwig M, Reimann H, Klix S, Waiczies S, Seeliger E. How bold is blood oxygenation level-dependent (BOLD) magnetic resonance imaging of the kidney? Opportunities, challenges and future directions. Acta Physiol (Oxf) 2015; 213:19-38. [PMID: 25204811 DOI: 10.1111/apha.12393] [Citation(s) in RCA: 87] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2014] [Revised: 07/04/2014] [Accepted: 09/04/2014] [Indexed: 12/11/2022]
Abstract
Renal tissue hypoperfusion and hypoxia are key elements in the pathophysiology of acute kidney injury and its progression to chronic kidney disease. Yet, in vivo assessment of renal haemodynamics and tissue oxygenation remains a challenge. Many of the established approaches are invasive, hence not applicable in humans. Blood oxygenation level-dependent (BOLD) magnetic resonance imaging (MRI) offers an alternative. BOLD-MRI is non-invasive and indicative of renal tissue oxygenation. Nonetheless, recent (pre-) clinical studies revived the question as to how bold renal BOLD-MRI really is. This review aimed to deliver some answers. It is designed to inspire the renal physiology, nephrology and imaging communities to foster explorations into the assessment of renal oxygenation and haemodynamics by exploiting the powers of MRI. For this purpose, the specifics of renal oxygenation and perfusion are outlined. The fundamentals of BOLD-MRI are summarized. The link between tissue oxygenation and the oxygenation-sensitive MR biomarker T2∗ is outlined. The merits and limitations of renal BOLD-MRI in animal and human studies are surveyed together with their clinical implications. Explorations into detailing the relation between renal T2∗ and renal tissue partial pressure of oxygen (pO2 ) are discussed with a focus on factors confounding the T2∗ vs. tissue pO2 relation. Multi-modality in vivo approaches suitable for detailing the role of the confounding factors that govern T2∗ are considered. A schematic approach describing the link between renal perfusion, oxygenation, tissue compartments and renal T2∗ is proposed. Future directions of MRI assessment of renal oxygenation and perfusion are explored.
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Affiliation(s)
- T. Niendorf
- Berlin Ultrahigh Field Facility (B.U.F.F.); Max Delbrück Center for Molecular Medicine; Berlin Germany
| | - A. Pohlmann
- Berlin Ultrahigh Field Facility (B.U.F.F.); Max Delbrück Center for Molecular Medicine; Berlin Germany
| | - K. Arakelyan
- Berlin Ultrahigh Field Facility (B.U.F.F.); Max Delbrück Center for Molecular Medicine; Berlin Germany
- Institute of Physiology and Center for Cardiovascular Research (CCR); Charité - Universitätsmedizin Berlin; Berlin Germany
| | - B. Flemming
- Institute of Physiology and Center for Cardiovascular Research (CCR); Charité - Universitätsmedizin Berlin; Berlin Germany
| | - K. Cantow
- Institute of Physiology and Center for Cardiovascular Research (CCR); Charité - Universitätsmedizin Berlin; Berlin Germany
| | - J. Hentschel
- Berlin Ultrahigh Field Facility (B.U.F.F.); Max Delbrück Center for Molecular Medicine; Berlin Germany
| | - D. Grosenick
- Physikalisch-Technische Bundesanstalt (PTB); Berlin Germany
| | - M. Ladwig
- Institute of Physiology and Center for Cardiovascular Research (CCR); Charité - Universitätsmedizin Berlin; Berlin Germany
| | - H. Reimann
- Berlin Ultrahigh Field Facility (B.U.F.F.); Max Delbrück Center for Molecular Medicine; Berlin Germany
| | - S. Klix
- Berlin Ultrahigh Field Facility (B.U.F.F.); Max Delbrück Center for Molecular Medicine; Berlin Germany
| | - S. Waiczies
- Berlin Ultrahigh Field Facility (B.U.F.F.); Max Delbrück Center for Molecular Medicine; Berlin Germany
| | - E. Seeliger
- Institute of Physiology and Center for Cardiovascular Research (CCR); Charité - Universitätsmedizin Berlin; Berlin Germany
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Velroyen A, Bech M, Zanette I, Schwarz J, Rack A, Tympner C, Herrler T, Staab-Weijnitz C, Braunagel M, Reiser M, Bamberg F, Pfeiffer F, Notohamiprodjo M. X-ray phase-contrast tomography of renal ischemia-reperfusion damage. PLoS One 2014; 9:e109562. [PMID: 25299243 PMCID: PMC4192129 DOI: 10.1371/journal.pone.0109562] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2014] [Accepted: 09/02/2014] [Indexed: 01/28/2023] Open
Abstract
Purpose The aim of the study was to investigate microstructural changes occurring in unilateral renal ischemia-reperfusion injury in a murine animal model using synchrotron radiation. Material and Methods The effects of renal ischemia-reperfusion were investigated in a murine animal model of unilateral ischemia. Kidney samples were harvested on day 18. Grating-Based Phase-Contrast Imaging (GB-PCI) of the paraffin-embedded kidney samples was performed at a Synchrotron Radiation Facility (beam energy of 19 keV). To obtain phase information, a two-grating Talbot interferometer was used applying the phase stepping technique. The imaging system provided an effective pixel size of 7.5 µm. The resulting attenuation and differential phase projections were tomographically reconstructed using filtered back-projection. Semi-automated segmentation and volumetry and correlation to histopathology were performed. Results GB-PCI provided good discrimination of the cortex, outer and inner medulla in non-ischemic control kidneys. Post-ischemic kidneys showed a reduced compartmental differentiation, particularly of the outer stripe of the outer medulla, which could not be differentiated from the inner stripe. Compared to the contralateral kidney, after ischemia a volume loss was detected, while the inner medulla mainly retained its volume (ratio 0.94). Post-ischemic kidneys exhibited severe tissue damage as evidenced by tubular atrophy and dilatation, moderate inflammatory infiltration, loss of brush borders and tubular protein cylinders. Conclusion In conclusion GB-PCI with synchrotron radiation allows for non-destructive microstructural assessment of parenchymal kidney disease and vessel architecture. If translation to lab-based approaches generates sufficient density resolution, and with a time-optimized image analysis protocol, GB-PCI may ultimately serve as a non-invasive, non-enhanced alternative for imaging of pathological changes of the kidney.
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Affiliation(s)
- Astrid Velroyen
- Chair of Biomedical Physics, Department of Physics (E17), Munich, Bavaria, Germany
| | - Martin Bech
- Chair of Biomedical Physics, Department of Physics (E17), Munich, Bavaria, Germany
- Medical Radiation Physics, Lund University, Lund, Sweden
| | - Irene Zanette
- Chair of Biomedical Physics, Department of Physics (E17), Munich, Bavaria, Germany
| | - Jolanda Schwarz
- Chair of Biomedical Physics, Department of Physics (E17), Munich, Bavaria, Germany
| | - Alexander Rack
- European Synchrotron Radiation Facility, Grenoble, France
| | - Christiane Tympner
- Institute of Pathology, Ludwig-Maximilians-University Munich, Munich, Germany
| | - Tanja Herrler
- Department of General, Trauma, Hand, and Plastic Surgery, Ludwig-Maximilians-University Hospital Munich, Munich, Germany
| | - Claudia Staab-Weijnitz
- Institute for Clinical Radiology, University Hospitals Munich, Munich, Germany
- Comprehensive Pneumology Center, University Hospital, Ludwig-Maximilians-University and Helmholtz Zentrum Munich, Munich, Germany
| | - Margarita Braunagel
- Institute for Clinical Radiology, University Hospitals Munich, Munich, Germany
| | - Maximilian Reiser
- Institute for Clinical Radiology, University Hospitals Munich, Munich, Germany
| | - Fabian Bamberg
- Institute for Clinical Radiology, University Hospitals Munich, Munich, Germany
- Department of Radiology, University Hospital Tuebingen, Tuebingen, Germany
| | - Franz Pfeiffer
- Chair of Biomedical Physics, Department of Physics (E17), Munich, Bavaria, Germany
| | - Mike Notohamiprodjo
- Institute for Clinical Radiology, University Hospitals Munich, Munich, Germany
- Department of Radiology, University Hospital Tuebingen, Tuebingen, Germany
- * E-mail:
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Assessing lung transplantation ischemia-reperfusion injury by microcomputed tomography and ultrashort echo-time magnetic resonance imaging in a mouse model. Invest Radiol 2014; 49:23-8. [PMID: 24056111 DOI: 10.1097/rli.0b013e3182a53111] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
PURPOSE Ischemia-reperfusion injury (I/R) is a common early complication after lung transplantation. The purpose of this study was to compare ultrashort echo-time (UTE) sequences in magnetic resonance imaging (MRI) with a microcomputed tomography (micro-CT) reference standard for detection of I/R injury in a lung transplantation mouse model. MATERIALS AND METHODS Six mice (C57BL/6) underwent orthotopic lung transplantation using donor grafts that were exposed to 6-hour cold ischemia. Imaging was performed within 24 hours after the transplantation with high-resolution micro-CT (tube voltage, 50 kV; current, 500 mA; aluminum filter, 0.5 mm; voxel size, 35 × 35 × 35 μm³) and small-animal MRI at 4.7 T with a linearly polarized whole-body mouse coil. The imaging protocol comprised radial 3-dimensional UTE sequences with different echo times (repetition time, 8 milliseconds; echo time, 50/75/100/500/1500/3000/4000/5000 μs; voxel size, 350 × 350 × 350 μm³). Images were assessed visually and through calculation of contrast-to-noise ratio (CNR) values. Calculated S0 values and T2* transverse relaxation times (MRI) of lung parenchyma were compared with Hounsfield unit (HU) density in micro-CT images. Receiver operating characteristic curves and area under the curve values were calculated for comparison of diagnostic power. All samples underwent a histologic examination. RESULTS The results of both UTE MRI and micro-CT showed an excellent depiction of pulmonary infiltration due to I/R injury, with MRI exhibiting a significantly higher CNR (mean [SD] CNR MRI, 19.7 [8.0]; mean [SD] CNR micro-CT, 10.3 [2.5]; P < 0.001). Measured parametrical values were as follows: mean (SD) HU, -416 (120); mean (SD) S0 value, 1655 (440); mean (SD) T2*, 895 (870) μs for the non-transplanted right lung and mean (SD) HU, 29 (35); mean (SD) S0 value, 2310 (300); and mean (SD) T2*, 4550 (3230) μs for the transplanted left lung. Slight infiltration could be better discriminated with micro-CT, whereas, in strong infiltration, a better contrast was provided by UTE MRI. The area under the curve values resulting from the receiver operating characteristic curve analysis were 0.99 for HU density, 0.89 for S₀, 0.96 for T2*, and 0.98 for the combination of S₀ and T2*. CONCLUSIONS Results show that MRI of the lung has a similar diagnostic power compared with that of micro-CT regarding the detection of I/R injury after experimental lung transplantation. Both modalities provide complementary information in the assessment of dense and slight infiltration in the early phase after lung transplantation. Therefore, UTE MRI seems to be a promising addition to computed tomographic imaging in the assessment of I/R injury after lung transplantation.
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Chen J, Pan H, Lanza GM, Wickline SA. Perfluorocarbon nanoparticles for physiological and molecular imaging and therapy. Adv Chronic Kidney Dis 2013; 20:466-78. [PMID: 24206599 DOI: 10.1053/j.ackd.2013.08.004] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2013] [Revised: 08/20/2013] [Accepted: 08/20/2013] [Indexed: 11/11/2022]
Abstract
Herein, we review the use of non-nephrotoxic perfluorocarbon nanoparticles (PFC NPs) for noninvasive detection and therapy of kidney diseases, and we provide a synopsis of other related literature pertinent to their anticipated clinical application. Recent reports indicate that PFC NPs allow for quantitative mapping of kidney perfusion and oxygenation after ischemia-reperfusion injury with the use of a novel multinuclear (1)H/(19)F magnetic resonance imaging approach. Furthermore, when conjugated with targeting ligands, the functionalized PFC NPs offer unique and quantitative capabilities for imaging inflammation in the kidney of atherosclerotic ApoE-null mice. In addition, PFC NPs can facilitate drug delivery for treatment of inflammation, thrombosis, and angiogenesis in selected conditions that are comorbidities for kidney failure. The excellent safety profile of PFC NPs with respect to kidney injury positions these nanomedicine approaches as promising diagnostic and therapeutic candidates for treating and following acute and chronic kidney diseases.
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