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Renal blood flow using arterial spin labelling MRI and calculated filtration fraction in healthy adult kidney donors Pre-nephrectomy and post-nephrectomy

  • Magnetic Resonance
  • Published:
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Abstract

Objectives

Renal plasma flow (RPF) (derived from renal blood flow, RBF) and glomerular filtration rate (GFR) allow the determination of the filtration fraction (FF), which may have a role as a non-invasive renal biomarker. This is a hypothesis-generating pilot study assessing the effect of nephrectomy on renal function in healthy kidney donors.

Methods

Eight living kidney donors underwent arterial spin labelling (ASL) magnetic resonance imaging (MRI) and GFR measurement prior to and 1 year after nephrectomy. Chromium-51 labelled ethylenediamine tetraacetic acid (51Cr-EDTA) with multi-blood sampling was undertaken and GFR calculated. The RBF and GFR obtained were used to calculate FF.

Results

All donors showed an increase in single kidney GFR of 24 – 75 %, and all but two showed an increase in FF (−7 to +52 %) after nephrectomy. The increase in RBF, and hence RPF, post-nephrectomy was not as great as the increase in GFR in seven out of eight donors. As with any pilot study, the small number of donors and their relatively narrow age range are potential limiting factors.

Conclusions

The ability to measure RBF, and hence RPF, non-invasively, coupled with GFR measurement, allows calculation of FF, a biomarker that might provide a sensitive indicator of loss of renal reserve in potential donors.

Key Points

• Non-invasive MRI measured renal blood flow and calculated renal plasma flow.

• Effect of nephrectomy on blood flow and filtration in donors is presented.

• Calculated filtration fraction may be a useful new kidney biomarker.

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Acknowledgments

The authors would like to thank Kids Kidney Research for their support of this work. Dr. M Cutajar was supported by both Kids Kidney Research (kidskidneyresearch.org) and Kidney Research UK (kidneyresearchuk.org). Thanks also go to Dr. Martin King from UCL Institute of Child Health for helpful comments on the analysis, and to Ms. Rebecca Strawbridge for her invaluable work in patient recruitment.

The scientific guarantor of this publication is Dr. Christopher Clark. The authors of this manuscript declare no relationships with any companies, whose products or services may be related to the subject matter of the article. Dr. Martin King kindly provided statistical advice for this manuscript and Dr. Matthias Günther for providing the 3D GRASE ASL pulse sequence. Institutional review board approval was obtained. Written informed consent was obtained from all subjects in this study. This was an observational study performed at one institution.

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Authors and Affiliations

  1. Imaging and Biophysics Unit, Institute of Child Health, University College London, 30 Guilford Street, London, WC1N1EH, UK

    Marica Cutajar, Christopher A Clark & Isky Gordon

  2. Guy’s & St Thomas’ NHS Foundation Trust, Renal Unit, London, UK

    Rachel Hilton & Jonathon Olsburgh

  3. Department of Paediatric Nephrology, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK

    Stephen D Marks

  4. Department of Brain Repair and Rehabilitation, Institute of Neurology, University College London, London, UK

    David L Thomas

  5. Department of Radiology, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK

    Tina Banks

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  1. Marica Cutajar
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Correspondence to Isky Gordon.

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Cutajar, M., Hilton, R., Olsburgh, J. et al. Renal blood flow using arterial spin labelling MRI and calculated filtration fraction in healthy adult kidney donors Pre-nephrectomy and post-nephrectomy. Eur Radiol 25, 2390–2396 (2015). https://doi.org/10.1007/s00330-015-3594-6

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  • DOI: https://doi.org/10.1007/s00330-015-3594-6

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