Noninvasive evaluation of intrarenal oxygenation with BOLD MRI

Circulation
P V PrasadF H Epstein

Abstract

The countercurrent arrangement of capillary blood flow in the medulla of mammalian kidneys generates a gradient of oxygen tension between the renal cortex and the papillary tip that results in a state of relative hypoxia within the renal medulla. Exploration of the pathophysiological implications of medullary hypoxia has been hampered by the absence of a noninvasive technique to estimate intrarenal oxygenation in different zones of the kidney. In the present study, we demonstrate the feasibility of such a method on the basis of blood oxygenation level-dependent (BOLD) MRI, which allows sequential measurements in humans in response to a variety of physiological/ pharmacological stimuli in health and disease. BOLD MRI measurements were obtained in healthy young human subjects (n = 7), and the effects of three different pharmacological/physiological maneuvers that induce diuresis were studied. Spin-spin relaxation rate, R2*, was measured, which is directly related to the amount of deoxyhemoglobin in blood and in turn to tissue PO2. Furosemide but not acetazolamide (n = 6 each) increased medullary oxygenation (delta R2* = 7.62 Hz; P < .01), consistent with the separate sites of action of these diuretics in the nephron and with prev...Continue Reading

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