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Pediatric Nephrology
Published in: Pediatric Nephrology 11/2016

01-11-2016 | Original Article

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

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

Published in: Pediatric Nephrology | Issue 11/2016

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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.
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Metadata
Title
Renal tissue oxygenation in children with chronic kidney disease due to vesicoureteral reflux
Authors
Hassib Chehade
Bastien Milani
Annalisa Ansaloni
Christiane Anex
Isabelle Bassi
Maciej Piskunowicz
Matthias Stuber
Francois Cachat
Michel Burnier
Menno Pruijm
Publication date
01-11-2016
Publisher
Springer Berlin Heidelberg
Published in
Pediatric Nephrology / Issue 11/2016
Print ISSN: 0931-041X
Electronic ISSN: 1432-198X
DOI
https://doi.org/10.1007/s00467-016-3419-0

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