scholarly journals Diagnosis of Chronic Kidney Disease by Three-Dimensional Contrast-Enhanced Ultrasound Combined with Augmented Reality Medical Technology

2021 ◽  
Vol 2021 ◽  
pp. 1-12
Author(s):  
Yan Zhuang ◽  
Juanjuan Sun ◽  
Jiaqiang Liu

Chronic kidney disease is a worldwide clinical and public health problem. As a risk factor for cardiovascular and cerebrovascular diseases, the disease has gradually become one of the causes of morbidity and death. As a routine method of screening for kidney disease, ultrasound is very important in improving the rate of early detection and accuracy of chronic kidney disease. This article explores the value of applying 3D ultrasound in conjunction with augmented reality medical technology in chronic kidney disease, observing changes in kidney tumor at different stages with percutaneous 3D ultrasound in patients with chronic kidney disease. Volunteers with chronic kidney disease were selected for this experiment. Among them, 160 males and 140 females were diagnosed as chronic kidney disease by clinical or renal pathological biopsy, and they all met the K/DOQI diagnostic criteria for chronic kidney disease. The selected subjects met the criteria and were divided into 5 groups, each with 60 patients, to explore the correlation of properties such as three-dimensional ultrasound kidney volume in different stages of chronic kidney disease. Experiments have shown that, with the increase in the stages of chronic kidney disease, the elasticity and volume of the renal parenchyma decrease, and the resistance index of the renal artery becomes larger, P < 0.05 ; the difference is statistically significant, indicating that the elasticity of the renal parenchyma is associated with chronic kidney disease. The stage is negatively correlated, and the resistance index of the renal artery is positively correlated with the stage of chronic kidney disease. That is, as the stage of chronic kidney disease increases, the three-dimensional volume of the kidney shows a decreasing trend and the resistance index of the renal artery shows an increasing trend. Speed shows a declining trend and there is some correlation between the three.

2021 ◽  
Author(s):  
Yanli Huang ◽  
Xiaohang Wu ◽  
Ye Tao ◽  
Jialing Wu ◽  
Yumei Yan ◽  
...  

Abstract Objective: To explore of ultrasound combined with renal pathology score, and compare the application value of elastography, two-dimensional (2D) ultrasound, three-dimensional(3D) ultrasound and other ultrasound imaging methods in early chronic kidney diagnosis.Methods: Combined ultrasound and pathological scores. A retrospective analysis of 118 patients with chronic kidney disease examined in the department of nephrology of the author's hospital. 36 healthy who were normal in the same period were selected as the control group. Combined with the left kidney pathology score and multi-factor logistic regression analysis to evaluate independent predictors of early pathological injured in CKD, ROC curve analysis to evaluate the diagnostic efficacy of each ultrasound index. Statistical evaluation: The difference was statistically significant (P <0.05).Results: In patients with severely injured CKD, renal length, three-dimensional kidney volume, Renal interlobar artery RI, and AT all appear to be effective predictors. Among patients with moderate injured, only AT and RI were effective predictors. Among patients with mildly impaired CKD, AT has the highest diagnostic efficacy, but SWV has the highest sensitivity (83.8%) for detecting mild renal injured. The results confirm that the Renal interlobar artery AT is the strongest independent predictor of CKD injured.Conclusion: The results confirm that the Renal interlobar artery AT is the strongest independent predictor of CKD injured.


2017 ◽  
pp. 109-113
Author(s):  
Ba Lai Luu ◽  
Thanh Thao Nguyen

Objective: To describe the morphologic and hemodynamic changes of renal interlobar artery on ultrasonography, and to evaluate the relationship between RI and kidney size, glomerular filtration rate, and causes of chronic kidney disease. Materials and methods: A cross-sectional study of 50 chronic kidney disease patients from stage 3, and 50 healthy individuals. RI, peak systolic velocity (PSV), end diastolic velocity (EDV) of renal interlobar artery, renal size was measured. Results: The mean RI in chronic kidney disease group and healthy group was 0.68 ± 0.05 and 0.57 ± 0.04 (p <0.05), respectively. RI increases with the stage of chronic kidney disease. There were statistically significant differences in RI of renal lobar arteries between chronic pyelonephritis and chronic glomerulonephritis (p <0.05). There was strong negative correlation and a statistically significant difference between renal lobar renal artery RI with kidney size (horizontal, vertical and thickness) and glomerular filtration level. Conclusion: Renal artery resistance index in patients with chronic kidney disease was higher than in the healthy group. The greater the kidney failure is, the more reduction in size and renal function, and the more increase in renal artery resistance index. Key words: morphologic, hemodynamic, chronic kidney disease, ultrasonography


2012 ◽  
Vol 52 (January) ◽  
pp. 47-52
Author(s):  
Sugako Kobayashi ◽  
Yasuhisa Akaiwa ◽  
Masaru Takekubo ◽  
Osamu Namura ◽  
Norihiko Yoshimura ◽  
...  

2021 ◽  
Vol 44 (3) ◽  
pp. E19-24
Author(s):  
Kun-Kun Cao ◽  
Ning Ding ◽  
Xiao-We Li ◽  
Jia-Ming Zhong ◽  
Jian Zhai ◽  
...  

Purpose: Incidence of contrast induced nephropathy (CIN) and related risk factors in patients with liver cancer and chronic kidney disease after trans-catheter arterial chemoembolization (TACE) is higher. The purpose of this study was to investigate the feasibility and safety of TACE therapy in such patients. Methods: A retrospective analysis was performed on 103 patients with liver cancer and chronic kidney disease who underwent TACE treatments. TACE was performed according to Seldinger’s technique of arterial embolization with minor modifications. Based on CIN diagnostic criteria, patients were divided into non-CIN (n=89) and CIN (n=14) groups. Multiple clinical parameters were assessed for the two groups after TACE. Serum creatinine levels were measured 48-72 h after TACE. Results: Tumor size (>5 cm), TACE frequency, contrast agent dosage, solitary kidney, volume of iodized oil used in the TACE (ml) and urea levels were significantly higher in CIN group in comparison with the non-CIN group, while serum albumin and haemoglobin levels were significantly lower. Multivariate logistic regression analysis confirmed that the volume of iodized oil and TACE frequency were significantly positively correlated, and serum albumin level was negatively correlated in the CIN group. Conclusion: Volume of iodized oil, TACE frequency and low serum albumin levels were found to be independent risk factors for CIN after TACE. Thus, it is safe and feasible for hepatocellular carcinoma patients with chronic kidney disease to receive TACE treatment, but adverse events management after TACE needs to be addressed.


2020 ◽  
Vol 127 (Suppl_1) ◽  
Author(s):  
Angela C Castellanos ◽  
Bryon A Tompkins ◽  
Makoto Natsumeda ◽  
Victoria Florea ◽  
Monisha Banerjee ◽  
...  

Background: Heart failure with preserved ejection fraction (HFpEF) is a heterogeneous condition involving multiple comorbidities. Phenotypic classification of HFpEF associated with chronic kidney disease (CKD) manifests worse outcomes, compared to other HFpEF phenotypes. Few treatments improve morbidity and mortality in HFpEF. Stem cell therapy promotes cardiac repair in ischemic and non-ischemic cardiomyopathies. We hypothesized that allogeneic stem cell treatment ameliorates HFpEF in a large animal model of CKD. Methods: Yorkshire pigs (n=26) underwent 5/6 embolization-mediated nephrectomy and 4-weeks later received either: allogeneic mesenchymal stem cells (MSCs) (10х10 6 ), Kidney stem cells (KSC; 10х10 6 ), combination (ACCT; MSC+KSC; 1:1 ratio [5х10 6 each]), or placebo (n=6-7/ group). Cell therapy was delivered via the patent renal artery of the remnant kidney. RNAsec analysis compared placebo and ACCT groups. Results: Mean arterial pressure increased significantly in the placebo- (21.89±6.05 mmHg, p<0.0001) compared to the ACCT-group (p=0.04) at 12 weeks. Glomerular filtration rate improved significantly in the ACCT group (p=0.002). RNAseq analysis revealed a significant decrease in genes normally increased during kidney transplant rejection (q<10 -6 , NES = -2.32) in ACCT. Consistent with these results, there was a downregulation of canonical drivers of tubular damage and regeneration, including SOX9 (-2.39 fold, p=0.0004) and apoptosis of kidney cell types (-24.89 fold, p=0.004), including podocytes (-2.065 fold, p=0.04) with ACCT. ACCT administration also downregulated genes related to oxidative stress (-4.6 fold, p<0.0001), fibrosis, inflammatory response (-4.760 fold, p=<0.05), and renin-angiotensin signaling (-3.162 fold, p=0.024), which are related to cardiac hypertrophy pathways (-7.23, fold, p<0.0001). EDPVR improved in with ACCT (p=0.003), indicating decreased ventricular stiffness. Ejection fraction, relative wall thickness, and left ventricular mass did not differ between groups at 12 weeks. Conclusion: Intra-renal artery allogeneic cell therapy was safe. Beneficial effects were observed in the ACCT and MSC groups in the kidney and heart. These findings have important implications on the use of cell therapy for HFpEF and cardiorenal syndrome.


2019 ◽  
Vol 35 (6) ◽  
pp. 955-964 ◽  
Author(s):  
Charlotte E Buchanan ◽  
Huda Mahmoud ◽  
Eleanor F Cox ◽  
Thomas McCulloch ◽  
Benjamin L Prestwich ◽  
...  

Abstract Background Multi-parametric magnetic resonance imaging (MRI) provides the potential for a more comprehensive non-invasive assessment of organ structure and function than individual MRI measures, but has not previously been comprehensively evaluated in chronic kidney disease (CKD). Methods We performed multi-parametric renal MRI in persons with CKD (n = 22, 61 ± 24 years) who had a renal biopsy and measured glomerular filtration rate (mGFR), and matched healthy volunteers (HV) (n = 22, 61 ± 25 years). Longitudinal relaxation time (T1), diffusion-weighted imaging, renal blood flow (phase contrast MRI), cortical perfusion (arterial spin labelling) and blood-oxygen-level-dependent relaxation rate (R2*) were evaluated. Results MRI evidenced excellent reproducibility in CKD (coefficient of variation &lt;10%). Significant differences between CKD and HVs included cortical and corticomedullary difference (CMD) in T1, cortical and medullary apparent diffusion coefficient (ADC), renal artery blood flow and cortical perfusion. MRI measures correlated with kidney function in a combined CKD and HV analysis: estimated GFR correlated with cortical T1 (r = −0.68), T1 CMD (r = −0.62), cortical (r = 0.54) and medullary ADC (r = 0.49), renal artery flow (r = 0.78) and cortical perfusion (r = 0.81); log urine protein to creatinine ratio (UPCR) correlated with cortical T1 (r = 0.61), T1 CMD (r = 0.61), cortical (r = −0.45) and medullary ADC (r = −0.49), renal artery flow (r = −0.72) and cortical perfusion (r = −0.58). MRI measures (cortical T1 and ADC, T1 and ADC CMD, cortical perfusion) differed between low/high interstitial fibrosis groups at 30–40% fibrosis threshold. Conclusion Comprehensive multi-parametric MRI is reproducible and correlates well with available measures of renal function and pathology. Larger longitudinal studies are warranted to evaluate its potential to stratify prognosis and response to therapy in CKD.


2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Xin Li ◽  
Kristin Danielson ◽  
Innas Forsal ◽  
Ken Iseri ◽  
Lu Dai ◽  
...  

Abstract Background and Aims Transferrin saturation (TSAT) is an indicator of iron deficiency or overload, but its relationship with mortality in patients with different stages of chronic kidney disease (CKD) is unclear. We investigated the association of TSAT with mortality in CKD patients. Method In 479 CKD patients (97 CKD3-4 patients, 298 CKD5 non-dialysis patients and 84 peritoneal dialysis patients; median age 58 years, 67% males, 33% cardiovascular disease, CVD, and 29% diabetes), biomarkers of iron status (plasma iron, TSAT, transferrin and ferritin), systemic inflammation (high sensitivity C-reactive protein, hsCRP, and interleukin-6, IL-6) and nutritional status were assessed. During median follow-up of 35.6 months, 139 (29%) patients died, and 176 (37%) patients underwent renal transplantation. Patients were stratified into low (n=157) and high (n=322) TSAT tertile groups. All-cause and CVD mortality risk were analyzed with competing risk regression with renal transplantation as competing risk. Results TSAT [median 23% (IQR 17-30%)] was negatively associated with presence of DM and CVD, body mass index, hsCRP, IL-6, Framingham´s CVD risk score (FRS), erythropoietin resistance index (ERI) and iron supplementation, and positively associated with hemoglobin, ferritin and s-albumin. In competing risk analysis, low tertile of TSAT was independently associated with increased all-cause mortality risk (sHR=1.50, 95%CI 1.05-2.14) after adjusting for CKD stages, 1-SD of FRS, 1-SD of hemoglobin, 1-SD of hsCRP, 1-SD of ESA dose and iron supplementation (Figure 1). Conclusion TSAT was inversely associated with mortality risk in CKD patients. When evaluating clinical outcomes of CKD patients, iron status using TSAT as a predictive marker, should be considered.


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