BIOMAT Database Logo BIOMAT Database Logo

Effects of renal volume and single-kidney glomerular filtration rate on renal functional outcome in atherosclerotic renal artery stenosis. 2010

Ching M Cheung, and Constantina Chrysochou, and Ala'a E Shurrab, and David L Buckley, and Alistair Cowie, and Philip A Kalra
Department of Renal Medicine and Radiology, Salford Royal Hospital, Stott Lane, Salford M6 8HD, UK. mmmr4cmc@doctors.org.uk

BACKGROUND Renal functional outcome is unpredictable after revascularization of high-grade atherosclerotic renal artery stenosis (RAS). 'Hibernating' parenchyma describes acute parenchymal injury where renal dysfunction is potentially reversible with treatment of the stenosis. We analysed renal parenchymal volume (PV) and single-kidney glomerular filtration rate (SK-GFR) characteristics to identify kidneys with hibernating parenchyma and hence determine renal functional outcome after revascularization. METHODS Fifty patients with > or =50% RAS underwent baseline analyses: (i) PV using magnetic resonance imaging; (ii) radioisotopic SK-GFR. Twenty-one patients (27 kidneys) underwent renal revascularization and 29 medical therapy alone. RESULTS Patients with revascularized kidneys manifesting high PV:SK-GFR showed improvement in global estimated GFR compared to conservatively managed counterparts at 6 months and 1 year (6 months: 6.2 +/- 2.9 versus -3.7 +/- 6.8, P = 0.038; 1 year: 3.5 +/- 3.0 versus -5.1 +/- 5.1 ml/min/1.73 m(2), P = 0.021). Twelve revascularized patients (16 kidneys) underwent repeat SK-GFR 4 months post-revascularization. Six of 16 revascularized kidneys had high baseline PV:SK-GFR and showed improved SK-GFR compared to kidneys with low or normal PV:SK-GFR (6.3 +/- 2.0 versus -0.9 +/- 4.2 ml/min, P = 0.002). CONCLUSIONS Our data suggest that, after revascularization, GFR improvement is likely if there is a disproportionately higher baseline PV:SK-GFR in the RAS kidney. Analysing these parameters can potentially identify these 'hibernating' kidneys and aid determination of renal functional outcome in RAS.

UI MeSH Term Description Entries
D007668 Kidney Body organ that filters blood for the secretion of URINE and that regulates ion concentrations. Kidneys
D008279 Magnetic Resonance Imaging Non-invasive method of demonstrating internal anatomy based on the principle that atomic nuclei in a strong magnetic field absorb pulses of radiofrequency energy and emit them as radiowaves which can be reconstructed into computerized images. The concept includes proton spin tomographic techniques. Chemical Shift Imaging,MR Tomography,MRI Scans,MRI, Functional,Magnetic Resonance Image,Magnetic Resonance Imaging, Functional,Magnetization Transfer Contrast Imaging,NMR Imaging,NMR Tomography,Tomography, NMR,Tomography, Proton Spin,fMRI,Functional Magnetic Resonance Imaging,Imaging, Chemical Shift,Proton Spin Tomography,Spin Echo Imaging,Steady-State Free Precession MRI,Tomography, MR,Zeugmatography,Chemical Shift Imagings,Echo Imaging, Spin,Echo Imagings, Spin,Functional MRI,Functional MRIs,Image, Magnetic Resonance,Imaging, Magnetic Resonance,Imaging, NMR,Imaging, Spin Echo,Imagings, Chemical Shift,Imagings, Spin Echo,MRI Scan,MRIs, Functional,Magnetic Resonance Images,Resonance Image, Magnetic,Scan, MRI,Scans, MRI,Shift Imaging, Chemical,Shift Imagings, Chemical,Spin Echo Imagings,Steady State Free Precession MRI
D008297 Male Males
D012078 Renal Artery Obstruction Narrowing or occlusion of the RENAL ARTERY or arteries. It is due usually to ATHEROSCLEROSIS; FIBROMUSCULAR DYSPLASIA; THROMBOSIS; EMBOLISM, or external pressure. The reduced renal perfusion can lead to renovascular hypertension (HYPERTENSION, RENOVASCULAR). Renal Artery Stenosis,Obstruction, Renal Artery,Obstructions, Renal Artery,Renal Artery Obstructions,Renal Artery Stenoses,Stenoses, Renal Artery,Stenosis, Renal Artery
D001794 Blood Pressure PRESSURE of the BLOOD on the ARTERIES and other BLOOD VESSELS. Systolic Pressure,Diastolic Pressure,Pulse Pressure,Pressure, Blood,Pressure, Diastolic,Pressure, Pulse,Pressure, Systolic,Pressures, Systolic
D005260 Female Females
D005919 Glomerular Filtration Rate The volume of water filtered out of plasma through glomerular capillary walls into Bowman's capsules per unit of time. It is considered to be equivalent to INULIN clearance. Filtration Rate, Glomerular,Filtration Rates, Glomerular,Glomerular Filtration Rates,Rate, Glomerular Filtration,Rates, Glomerular Filtration
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000368 Aged A person 65 years of age or older. For a person older than 79 years, AGED, 80 AND OVER is available. Elderly
D000800 Angioplasty, Balloon Use of a balloon catheter for dilation of an occluded artery. It is used in treatment of arterial occlusive diseases, including renal artery stenosis and arterial occlusions in the leg. For the specific technique of BALLOON DILATION in coronary arteries, ANGIOPLASTY, BALLOON, CORONARY is available. Balloon Angioplasty,Dilation, Transluminal Arterial,Arterial Dilation, Transluminal,Arterial Dilations, Transluminal,Dilations, Transluminal Arterial,Transluminal Arterial Dilation,Transluminal Arterial Dilations

Related Publications

Ching M Cheung, and Constantina Chrysochou, and Ala'a E Shurrab, and David L Buckley, and Alistair Cowie, and Philip A Kalra
Atherosclerotic renal artery stenosis: flaws in estimated glomerular filtration rate and the problem of progressive kidney injury.
June 2011, Circulation. Cardiovascular interventions,
Ching M Cheung, and Constantina Chrysochou, and Ala'a E Shurrab, and David L Buckley, and Alistair Cowie, and Philip A Kalra
Effect of baseline glomerular filtration rate on renal function following stenting for atherosclerotic renal artery stenosis.
April 2010, Scandinavian journal of urology and nephrology,
Ching M Cheung, and Constantina Chrysochou, and Ala'a E Shurrab, and David L Buckley, and Alistair Cowie, and Philip A Kalra
Relationship between renal parenchymal volume and single kidney glomerular filtration rate before and after unilateral nephrectomy.
June 2011, Urology,
Ching M Cheung, and Constantina Chrysochou, and Ala'a E Shurrab, and David L Buckley, and Alistair Cowie, and Philip A Kalra
Ultrasound measured renal length versus low dose CT volume in predicting single kidney glomerular filtration rate.
September 2004, The British journal of radiology,
Ching M Cheung, and Constantina Chrysochou, and Ala'a E Shurrab, and David L Buckley, and Alistair Cowie, and Philip A Kalra
Slope-only glomerular filtration rate and single-sample glomerular filtration rate as measurements of the ratio of glomerular filtration rate to extracellular fluid volume.
April 2010, Nephrology (Carlton, Vic.),
Ching M Cheung, and Constantina Chrysochou, and Ala'a E Shurrab, and David L Buckley, and Alistair Cowie, and Philip A Kalra
Effect of isotonic volume expansion on glomerular filtration rate and renal hemodynamics in the developing rat kidney.
April 1980, Acta physiologica Scandinavica,
Ching M Cheung, and Constantina Chrysochou, and Ala'a E Shurrab, and David L Buckley, and Alistair Cowie, and Philip A Kalra
Effect of age, sex, and glomerular filtration rate on renal function outcome of living kidney donors.
December 1995, Transplantation,
Ching M Cheung, and Constantina Chrysochou, and Ala'a E Shurrab, and David L Buckley, and Alistair Cowie, and Philip A Kalra
Validity of estimated glomerular filtration rates for assessment of renal function after renal artery stenting in patients with atherosclerotic renal artery stenosis.
May 2014, JACC. Cardiovascular interventions,
Ching M Cheung, and Constantina Chrysochou, and Ala'a E Shurrab, and David L Buckley, and Alistair Cowie, and Philip A Kalra
Effects of sulindac on renal prostaglandins and glomerular filtration rate.
August 1991, The American journal of medicine,
Ching M Cheung, and Constantina Chrysochou, and Ala'a E Shurrab, and David L Buckley, and Alistair Cowie, and Philip A Kalra
Renal reserve: a functional view of glomerular filtration rate.
September 1995, Seminars in nephrology,
Copied contents to your clipboard!