Magnetic Resonance Elastography-derived Stiffness Predicts Renal Function Loss and Is Associated With Microvascular Inflammation in Kidney Transplant Recipients
Background. Organ stiffening can be caused by inflammation and fibrosis, processes that are common causes of transplant kidney dysfunction. Magnetic resonance elastography (MRE) is a contrast-free, noninvasive imaging modality that measures kidney stiffness. The objective of this study was to assess...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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Wolters Kluwer
2022-06-01
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| Series: | Transplantation Direct |
| Online Access: | http://journals.lww.com/transplantationdirect/fulltext/10.1097/TXD.0000000000001334 |
| _version_ | 1818218749648437248 |
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| author | Anwar S. Shatil, MSc Anish Kirpalani, MASc Eyesha Younus, PhD Pascal N. Tyrrell, PhD Adriana Krizova, MD Darren A. Yuen, MD, FRCPC, PhD |
| author_facet | Anwar S. Shatil, MSc Anish Kirpalani, MASc Eyesha Younus, PhD Pascal N. Tyrrell, PhD Adriana Krizova, MD Darren A. Yuen, MD, FRCPC, PhD |
| author_sort | Anwar S. Shatil, MSc |
| collection | DOAJ |
| description | Background. Organ stiffening can be caused by inflammation and fibrosis, processes that are common causes of transplant kidney dysfunction. Magnetic resonance elastography (MRE) is a contrast-free, noninvasive imaging modality that measures kidney stiffness. The objective of this study was to assess the ability of MRE to serve as a prognostic factor for renal outcomes.
Methods. Patients were recruited from the St Michael’s Hospital Kidney Transplant Clinic. Relevant baseline demographic, clinical, and Banff histologic information, along with follow-up estimated glomerular filtration rate (eGFR) data, were recorded. Two-dimensional gradient-echo MRE imaging was performed to obtain kidney “stiffness” maps. Binary logistic regression analyses were performed to examine for relationships between stiffness and microvascular inflammation score. Linear mixed-effects modeling was used to assess the relationship between stiffness and eGFR change over time controlling for other baseline variables. A G2-likelihood ratio Chi-squared test was performed to compare between the baseline models with and without “stiffness.”
Results. Sixty-eight transplant kidneys were scanned in 66 patients (mean age 56 ± 12 y, 24 females), with 38 allografts undergoing a contemporaneous biopsy. Mean transplant vintage was 7.0 ± 6.8 y. In biopsied allografts, MRE-derived allograft stiffness was associated only with microvascular inflammation (Banff g + ptc score, Spearman ρ = 0.43, P = 0.01), but no other histologic parameters. Stiffness was negatively associated with eGFR change over time (Stiffness × Time interaction β = –0.80, P < 0.0001), a finding that remained significant even when adjusted for biopsy status and baseline variables (Stiffness × Time interaction β = –0.46, P = 0.04). Conversely, the clinical models including “stiffness” showed significantly better fit (P = 0.04) compared with the baseline clinical models without “stiffness.”
Conclusions. MRE-derived renal stiffness provides important prognostic information regarding renal function loss for patients with allograft dysfunction, over and above what is provided by current clinical variables. |
| first_indexed | 2024-12-12T07:28:43Z |
| format | Article |
| id | doaj.art-21ba657eccec4e03bebbc7939f4bda07 |
| institution | Directory Open Access Journal |
| issn | 2373-8731 |
| language | English |
| last_indexed | 2024-12-12T07:28:43Z |
| publishDate | 2022-06-01 |
| publisher | Wolters Kluwer |
| record_format | Article |
| series | Transplantation Direct |
| spelling | doaj.art-21ba657eccec4e03bebbc7939f4bda072022-12-22T00:33:04ZengWolters KluwerTransplantation Direct2373-87312022-06-0186e133410.1097/TXD.0000000000001334202206000-00008Magnetic Resonance Elastography-derived Stiffness Predicts Renal Function Loss and Is Associated With Microvascular Inflammation in Kidney Transplant RecipientsAnwar S. Shatil, MSc0Anish Kirpalani, MASc1Eyesha Younus, PhD2Pascal N. Tyrrell, PhD3Adriana Krizova, MD4Darren A. Yuen, MD, FRCPC, PhD51 Department of Medical Imaging, St. Michael’s Hospital, Unity Health Toronto, Toronto, ON, Canada.1 Department of Medical Imaging, St. Michael’s Hospital, Unity Health Toronto, Toronto, ON, Canada.1 Department of Medical Imaging, St. Michael’s Hospital, Unity Health Toronto, Toronto, ON, Canada.5 Department of Medical Imaging, Department of Statistical Sciences, Institute of Medical Science, University of Toronto, Toronto, ON, Canada.6 Department of Laboratory Medicine and Pathobiology, St. Michael’s Hospital, Unity Health Toronto, Toronto, ON, Canada.3 Keenan Research Centre for Biomedical Science, St. Michael’s Hospital, Unity Health Toronto, Toronto, ON, Canada.Background. Organ stiffening can be caused by inflammation and fibrosis, processes that are common causes of transplant kidney dysfunction. Magnetic resonance elastography (MRE) is a contrast-free, noninvasive imaging modality that measures kidney stiffness. The objective of this study was to assess the ability of MRE to serve as a prognostic factor for renal outcomes. Methods. Patients were recruited from the St Michael’s Hospital Kidney Transplant Clinic. Relevant baseline demographic, clinical, and Banff histologic information, along with follow-up estimated glomerular filtration rate (eGFR) data, were recorded. Two-dimensional gradient-echo MRE imaging was performed to obtain kidney “stiffness” maps. Binary logistic regression analyses were performed to examine for relationships between stiffness and microvascular inflammation score. Linear mixed-effects modeling was used to assess the relationship between stiffness and eGFR change over time controlling for other baseline variables. A G2-likelihood ratio Chi-squared test was performed to compare between the baseline models with and without “stiffness.” Results. Sixty-eight transplant kidneys were scanned in 66 patients (mean age 56 ± 12 y, 24 females), with 38 allografts undergoing a contemporaneous biopsy. Mean transplant vintage was 7.0 ± 6.8 y. In biopsied allografts, MRE-derived allograft stiffness was associated only with microvascular inflammation (Banff g + ptc score, Spearman ρ = 0.43, P = 0.01), but no other histologic parameters. Stiffness was negatively associated with eGFR change over time (Stiffness × Time interaction β = –0.80, P < 0.0001), a finding that remained significant even when adjusted for biopsy status and baseline variables (Stiffness × Time interaction β = –0.46, P = 0.04). Conversely, the clinical models including “stiffness” showed significantly better fit (P = 0.04) compared with the baseline clinical models without “stiffness.” Conclusions. MRE-derived renal stiffness provides important prognostic information regarding renal function loss for patients with allograft dysfunction, over and above what is provided by current clinical variables.http://journals.lww.com/transplantationdirect/fulltext/10.1097/TXD.0000000000001334 |
| spellingShingle | Anwar S. Shatil, MSc Anish Kirpalani, MASc Eyesha Younus, PhD Pascal N. Tyrrell, PhD Adriana Krizova, MD Darren A. Yuen, MD, FRCPC, PhD Magnetic Resonance Elastography-derived Stiffness Predicts Renal Function Loss and Is Associated With Microvascular Inflammation in Kidney Transplant Recipients Transplantation Direct |
| title | Magnetic Resonance Elastography-derived Stiffness Predicts Renal Function Loss and Is Associated With Microvascular Inflammation in Kidney Transplant Recipients |
| title_full | Magnetic Resonance Elastography-derived Stiffness Predicts Renal Function Loss and Is Associated With Microvascular Inflammation in Kidney Transplant Recipients |
| title_fullStr | Magnetic Resonance Elastography-derived Stiffness Predicts Renal Function Loss and Is Associated With Microvascular Inflammation in Kidney Transplant Recipients |
| title_full_unstemmed | Magnetic Resonance Elastography-derived Stiffness Predicts Renal Function Loss and Is Associated With Microvascular Inflammation in Kidney Transplant Recipients |
| title_short | Magnetic Resonance Elastography-derived Stiffness Predicts Renal Function Loss and Is Associated With Microvascular Inflammation in Kidney Transplant Recipients |
| title_sort | magnetic resonance elastography derived stiffness predicts renal function loss and is associated with microvascular inflammation in kidney transplant recipients |
| url | http://journals.lww.com/transplantationdirect/fulltext/10.1097/TXD.0000000000001334 |
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