Kidney Week

Abstract: PUB112

MRI-Based Kidney Volume and Resistive Index in Patients with Progressive vs. Stable Diabetic Kidney Disease (DKD)

Session Information

• Publication Only

Category: Diabetic Kidney Disease

• 702 Diabetic Kidney Disease: Clinical

Authors

• Hockings, Paul, Antaros Medical, Molndal, Sweden

Paul Hockings, PhD

• Makvandi, Kianoush, Sahlgrenska universitetssjukhuset, Goteborg, Sweden

Kianoush Makvandi, MD

• Unwin, Robert J., University College London, London, United Kingdom

Robert J. Unwin, MBChB, PhD, ScD

• Hulthe, Johannes, Antaros Medical, Molndal, Sweden

Johannes Hulthe, MD, PhD, MBA

• Baid-Agrawal, Seema, Sahlgrenska universitetssjukhuset, Goteborg, Sweden

Seema Baid-Agrawal, MD, FASN

Background

Multiparametric Magnetic Resonance Imaging (MRI) can non-invasively assess kidney structure and function but there are few longitudinal studies.

Methods

In this prospective study:
- 38 DKD subjects aged 18–79 years and 20 age- and gender-matched healthy volunteers (HV) were included at baseline
- 31 DKD subjects (2 stage 2, 13 stage 3, 14 stage 4, and 2 stage 5) and 17 HV were re-examined at 2 years ± 6 months

Measured glomerular filtration rate (mGFR) was obtained using iohexol clearance. Kidney volume and renal artery resistive index (RARI) were measured by MRI.

Subjects were classed as stable (S) or as progressors (P) if they met at least one of the following criteria at 2 years:
- decrease in mGFR slope of >5 mL/year/1.73m²
- worsening UACR category
- any major adverse kidney event defined as:
>sustained decrease in eGFR of >40%
>doubling of serum creatinine from baseline
>development of kidney failure with mGFR <15 ml/min/1.73m²
>death from renal cause

Results

8/31 (26%) DKD subjects and 4/17 (24%) HVs progressed. Mean 2-year mGFR decline in DKD patients was 2.7±5.4 and in HV 1.9±10.7 (ml/min/1.73m²). Figure 1 shows correlation between both baseline and 2-year kidney volumes and RARI (R² 0.91 and 0.78, respectively). Figure 2 shows changes in kidney volume and RARI for HV and DKD subjects who were either stable (S) or progressors (P).

Conclusion

Baseline vs 2-year follow up for both kidney volumes and RARI are highly correlated. Progressors tend to have larger decreases in kidney volume than stable subjects. Subjects with DKD tend to have larger increases in RARI than HV subjects. Larger studies are needed to confirm these results.

Figure 1: Correlation between baseline and 2-year kidney volumes and RARI.

Figure 2: Changes in kidney volume and RARI for Healthy Volunteers (HV) and subjects with Diabetic Kidney Disease (DKD) who were either stable (S) or progressors (P).

Funding

• Commercial Support – Antaros Medical; AstraZeneca