Universität zu Köln

Siedek, Florian, Persigehl, Thorsten, Mueller, Roman-Ulrich, Burst, Volker, Benzing, Thomas, Maintz, David and Haneder, Stefan (2018). Assessing renal changes after remote ischemic preconditioning (RIPC) of the upper extremity using BOLD imaging at 3T. Magn. Reson. Mat. Phys. Biol. Med., 31 (3). S. 367 - 375. NEW YORK: SPRINGER. ISSN 1352-8661

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Abstract

Acute kidney injury (AKI) is an important risk factor for a number of adverse outcomes including end-stage renal disease and cardiovascular morbidity and mortality. Whilst many clinical situations that can induce AKI are known-e.g. drug toxicity, contrast agent exposure or ischemia during surgery-targeted preventive or therapeutic measures are still lacking. As to renoprotective strategies, remote ischemic preconditioning (RIPC) is one of the most promising novel approaches and has been examined by a number of clinical trials. The aim of this study was to use blood oxygenation level-dependent (BOLD) MRI as a surrogate parameter to assess the effect of RIPC in healthy volunteers. In this IRB-approved, prospective study, 40 healthy volunteers were stratified with 20 undergoing an RIPC procedure (i.e. RIPC group) with a transient ischemia of the right arm, and 20 undergoing a sham procedure. Before and after the procedure, both kidneys of all participants were scanned using a 12-echo mGRE sequence for functional BOLD imaging at 3T. For each volunteer, 180 ROIs were placed in the cortex and the medulla of the kidneys. Ultimately, R2* values, which have an inverse correlation with the oxygenation level of tissue, were averaged for the RIPC and control groups. Following intervention, mean R2* values significantly decreased in the RIPC group in both the cortex (18.6 +/- 2.3 vs. 17.5 +/- 1.7 Hz; p = 0.0047) and medulla (34 +/- 5.2 vs. 32.2 +/- 4.2 Hz; p = 0.0001). However, no significant differences were observed in the control group. RIPC can be non-invasively assessed in healthy volunteers using BOLD MRI at 3T, demonstrating a higher oxygen content in kidney tissue. This study presents a first-in-man trial establishing a quantifiable readout of RIPC and its effects on kidney physiology. BOLD measurements may advance clinical trials in further evaluating RIPC for future clinical care.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Siedek, Florian UNSPECIFIED UNSPECIFIED UNSPECIFIED Persigehl, Thorsten UNSPECIFIED UNSPECIFIED UNSPECIFIED Mueller, Roman-Ulrich UNSPECIFIED UNSPECIFIED UNSPECIFIED Burst, Volker UNSPECIFIED UNSPECIFIED UNSPECIFIED Benzing, Thomas UNSPECIFIED UNSPECIFIED UNSPECIFIED Maintz, David UNSPECIFIED UNSPECIFIED UNSPECIFIED Haneder, Stefan UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-185317
DOI:	10.1007/s10334-017-0658-4
Journal or Publication Title:	Magn. Reson. Mat. Phys. Biol. Med.
Volume:	31
Number:	3
Page Range:	S. 367 - 375
Date:	2018
Publisher:	SPRINGER
Place of Publication:	NEW YORK
ISSN:	1352-8661
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language CONTRAST-INDUCED NEPHROPATHY; ACUTE KIDNEY INJURY; INTRARENAL OXYGENATION; REPERFUSION INJURY; MRI; PREVENTION; PROTECTION; MEDIA; TRIAL; REVASCULARIZATION Multiple languages Radiology, Nuclear Medicine & Medical Imaging Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/18531