Associations of Kidney Functional Magnetic Resonance Imaging Biomarkers with Markers of Inflammation in Individuals with CKD

医学 炎症 四分位间距 磁共振成像 内科学 肾功能 纤维化 C反应蛋白 全身炎症 肾脏疾病 生物标志物 胃肠病学 放射科 生物 生物化学
作者
J. M. Trujillo,Manal Alotaibi,Nay Seif,Xuan Cai,Brett Larive,Jennifer Gassman,Kalani L. Raphael,Alfred K. Cheung,Dominic S. Raj,Linda F. Fried,Stuart M. Sprague,Geoffrey A. Block,Michel Chonchol,John P. Middleton,Myles Wolf,Joachim H. Ix,Pottumarthi V. Prasad,Tamara Isakova,Anand Srivastava
出处
期刊:Kidney360 [American Society of Nephrology (ASN)]
卷期号:5 (5): 681-689
标识
DOI:10.34067/kid.0000000000000437
摘要

Key Points Lower baseline apparent diffusion coefficient, indicative of greater cortical fibrosis, correlated with higher baseline concentrations of serum markers of inflammation. No association between baseline cortical R2* and baseline serum markers of inflammation were found. Baseline kidney functional magnetic resonance imaging biomarkers of fibrosis and oxygenation were not associated with changes in inflammatory markers over time, which may be due to small changes in kidney function in the study. Background Greater fibrosis and decreased oxygenation may amplify systemic inflammation, but data on the associations of kidney functional magnetic resonance imaging (fMRI) measurements of fibrosis (apparent diffusion coefficient [ADC]) and oxygenation (relaxation rate [R2*]) with systemic markers of inflammation are limited. Methods We evaluated associations of baseline kidney fMRI-derived ADC and R2* with baseline and follow-up serum IL-6 and C-reactive protein (CRP) in 127 participants from the CKD Optimal Management with Binders and NicotinamidE trial, a randomized, 12-month trial of nicotinamide and lanthanum carbonate versus placebo in individuals with CKD stages 3–4. Cross-sectional analyses of baseline kidney fMRI biomarkers and markers of inflammation used multivariable linear regression. Longitudinal analyses of baseline kidney fMRI biomarkers and change in markers of inflammation over time used linear mixed-effects models. Results Mean±SD eGFR, ADC, and R2* were 32.2±8.7 ml/min per 1.73 m 2 , 1.46±0.17×10 −3 mm 2 /s, and 20.3±3.1 s −1 , respectively. Median (interquartile range) IL-6 and CRP were 3.7 (2.4–4.9) pg/ml and 2.8 (1.2–6.3) mg/L, respectively. After multivariable adjustment, IL-6 and CRP were 13.1% and 27.3% higher per 1 SD decrease in baseline cortical ADC, respectively. Baseline cortical R2* did not have a significant association with IL-6 or CRP. Mean annual IL-6 and CRP slopes were 0.98 pg/ml per year and 0.91 mg/L per year, respectively. Baseline cortical ADC and R2* did not have significant associations with change in IL-6 or CRP over time. Conclusions Lower cortical ADC, suggestive of greater fibrosis, was associated with higher systemic inflammation. Baseline kidney fMRI biomarkers did not associate with changes in systemic markers of inflammation over time.
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