Renal Tissue Oxygenation Monitoring—An Opportunity to Improve Kidney Outcomes in the Vulnerable Neonatal Population

Background: Blood oxygen level-dependent magnetic resonance imaging (BOLD-MRI) has been widely used to assess renal oxygenation changes in different kidney diseases in recent years. This study was designed to evaluate and compare renal tissue oxygenation using 2 BOLD-MRI analysis methods, namely, the regional and whole-kidney region of interest (ROI) selection methods. Methods: The study ended up with 10 healthy controls and 40 chronic kidney disease (CKD) patients without dialysis. Their renal BOLD-MRI data were analyzed using whole-kidney ROI selection method and compared with regional ROI selection method. Results: We found the cortical, medullary, and whole-kidney R2* values were significantly higher in CKD patients than those in controls. Compared with the regional ROI selection method, the whole-kidney ROI selection method yielded higher cortical R2* values in both controls and CKD patients. The whole-kidney R2* values of deteriorating renal function group were significantly higher than those in stable renal function group. Conclusions: Cortical and medullary oxygenation was decreased significantly in CKD patients compared with the healthy controls, particularly in the medulla. The whole-kidney R2* values were positively correlated with kidney function and inversely correlated with the estimated glomerular filtration rate and effective renal plasma flow. Whole-Kidney R2* value might effectively predict the progression of renal function in patients with CKD.

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RENAL TISSUE OXYGENATION FOLLOWING INDUCED HYPOTENSION IN DOGS

British Journal of Anaesthesia ◽

10.1093/bja/56.9.1037 ◽

1984 ◽

Vol 56 (9) ◽

pp. 1037-1043 ◽

Cited By ~ 3

Author(s):

R. BEHNIA ◽

E. KOUSHANPOUR ◽

T.K. GOLDSTICK ◽

H.W. LlNDE ◽

R. OSBORN

Keyword(s):

Tissue Oxygenation ◽

Renal Tissue ◽

Induced Hypotension

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Utilization of Brain Tissue Oxygenation Monitoring and Association with Mortality Following Severe Traumatic Brain Injury

Neurocritical Care ◽

10.1007/s12028-021-01394-y ◽

2021 ◽

Author(s):

Jordan M. Komisarow ◽

Camilo Toro ◽

Jonathan Curley ◽

Brianna Mills ◽

Christopher Cho ◽

...

Keyword(s):

Traumatic Brain Injury ◽

Brain Injury ◽

Brain Tissue ◽

Severe Traumatic Brain Injury ◽

Tissue Oxygenation ◽

Brain Tissue Oxygenation ◽

Oxygenation Monitoring

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Use of near-infrared spectroscopy (NIRS) in cerebral tissue oxygenation monitoring in neonates

Biomedical Papers ◽

10.5507/bp.2017.012 ◽

2017 ◽

Vol 161 (2) ◽

pp. 128-133 ◽

Cited By ~ 4

Author(s):

Rene Gumulak ◽

Lucia Casnocha Lucanova ◽

Mirko Zibolen

Keyword(s):

Infrared Spectroscopy ◽

Near Infrared Spectroscopy ◽

Near Infrared ◽

Tissue Oxygenation ◽

Cerebral Tissue ◽

Cerebral Tissue Oxygenation ◽

Oxygenation Monitoring

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Measurement of renal tissue oxygenation with blood oxygen level-dependent MRI and oxygen transit modeling

AJP Renal Physiology ◽

10.1152/ajprenal.00575.2013 ◽

2014 ◽

Vol 306 (6) ◽

pp. F579-F587 ◽

Cited By ~ 29

Author(s):

Jeff L. Zhang ◽

Glen Morrell ◽

Henry Rusinek ◽

Lizette Warner ◽

Pierre-Hugues Vivier ◽

...

Keyword(s):

Tissue Oxygenation ◽

Human Subjects ◽

Blood Oxygen Level Dependent ◽

Renal Tissue ◽

Blood Oxygen ◽

Oxygen Level ◽

Blood Oxygen Level ◽

Healthy Human ◽

Bold Mri ◽

Before And After

Blood oxygen level-dependent (BOLD) MRI data of kidney, while indicative of tissue oxygenation level (Po2), is in fact influenced by multiple confounding factors, such as R2, perfusion, oxygen permeability, and hematocrit. We aim to explore the feasibility of extracting tissue Po2 from renal BOLD data. A method of two steps was proposed: first, a Monte Carlo simulation to estimate blood oxygen saturation (SHb) from BOLD signals, and second, an oxygen transit model to convert SHb to tissue Po2. The proposed method was calibrated and validated with 20 pigs (12 before and after furosemide injection) in which BOLD-derived tissue Po2 was compared with microprobe-measured values. The method was then applied to nine healthy human subjects (age: 25.7 ± 3.0 yr) in whom BOLD was performed before and after furosemide. For the 12 pigs before furosemide injection, the proposed model estimated renal tissue Po2 with errors of 2.3 ± 5.2 mmHg (5.8 ± 13.4%) in cortex and −0.1 ± 4.5 mmHg (1.7 ± 18.1%) in medulla, compared with microprobe measurements. After injection of furosemide, the estimation errors were 6.9 ± 3.9 mmHg (14.2 ± 8.4%) for cortex and 2.6 ± 4.0 mmHg (7.7 ± 11.5%) for medulla. In the human subjects, BOLD-derived medullary Po2 increased from 16.0 ± 4.9 mmHg (SHb: 31 ± 11%) at baseline to 26.2 ± 3.1 mmHg (SHb: 53 ± 6%) at 5 min after furosemide injection, while cortical Po2 did not change significantly at ∼58 mmHg (SHb: 92 ± 1%). Our proposed method, validated with a porcine model, appears promising for estimating tissue Po2 from renal BOLD MRI data in human subjects.

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Elevated renal tissue oxygenation in premature fetal growth restricted neonates: An observational study

PLoS ONE ◽

10.1371/journal.pone.0204268 ◽

2018 ◽

Vol 13 (9) ◽

pp. e0204268 ◽

Cited By ~ 4

Author(s):

Fieke Terstappen ◽

Nina D. Paauw ◽

Thomas Alderliesten ◽

Jaap A. Joles ◽

Daniel C. Vijlbrief ◽

...

Keyword(s):

Observational Study ◽

Fetal Growth ◽

Tissue Oxygenation ◽

Renal Tissue

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Abstract 9839: Beta Blockers Improve Renal Tissue Oxygenation in Hypertensive Patients Suspected of Renal Artery Stenosis

Circulation ◽

10.1161/circ.132.suppl_3.9839 ◽

2015 ◽

Vol 132 (suppl_3) ◽

Author(s):

Michael E Hall ◽

Michael V Rocco ◽

Timothy M Morgan ◽

Craig A Hamilton ◽

Jennifer H Jordan ◽

...

Keyword(s):

Blood Flow ◽

Renal Artery ◽

Renal Artery Stenosis ◽

Beta Blocker ◽

Tissue Oxygenation ◽

Beta Blockers ◽

Renal Tissue ◽

Artery Stenosis ◽

Blocker Therapy ◽

Hypertensive Patients

Background: Chronic renal hypoxia influences the progression of chronic kidney disease (CKD). Blood oxygen level dependent (BOLD) magnetic resonance (MR) is a noninvasive tool for assessment of renal tissue oxygenation. Beta blockers reduce cardiovascular mortality in patients with CKD and systolic heart failure, however the mechanisms of this benefit remain unclear. We sought to determine the association between beta blocker use, renal cortical and medullary oxygenation, and renal blood flow in hypertensive patients suspected of renal artery stenosis. Hypothesis: Chronic receipt of beta blockers will be associated with improved renal tissue oxygenation as assessed by BOLD MR. Methods: We measured renal cortical and medullary oxygenation using BOLD MR and renal artery blood flow using MR phase contrast techniques in 38 participants suspected of renal artery stenosis. Results: Chronic beta blocker therapy was associated with improved renal cortical (p=0.0007) and medullary (p=0.03) oxygenation (Figure). Receipt of angiotensin converting enzyme inhibitors or angiotensin receptor blockers was associated with reduced medullary oxygenation (p=0.01). In a multivariable model including gender, hemoglobin, diabetes, loop diuretic use, and mineralocorticoid use, chronic receipt of beta blockers was the only significant predictor of renal tissue oxygenation (β= 8.4, p=0.008). Conclusions: Beta blocker therapy was associated with improved renal oxygenation independent of renal blood flow suggesting may these findings may be related to reduced renal oxygen consumption. In addition to their known benefits to reduce cardiovascular mortality in patients with renal disease, beta blockers may reduce or prevent progression of renal dysfunction in patients with hypertension, diabetes, and renovascular disease. These observations may have important implications for treatment of patients with CKD.

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