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

Jacquelyn Trujillo, The Graduate School, Northwestern University Feinberg School of Medicine, Chicago, IL.
Manal Alotaibi, Division of Nephrology and Hypertension, Center for Translational Metabolism and Health, Institute for Public Health and Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL.
Nay Seif, Division of Nephrology and Hypertension, Center for Translational Metabolism and Health, Institute for Public Health and Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL.
Xuan Cai, Division of Nephrology and Hypertension, Center for Translational Metabolism and Health, Institute for Public Health and Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL.
Brett Larive, Department of Quantitative Health Sciences, Cleveland Clinic, Cleveland, OH.
Jennifer Gassman, Department of Quantitative Health Sciences, Cleveland Clinic, Cleveland, OH.
Kalani L. Raphael, Division of Nephrology and Hypertension, University of Utah Health, Salt Lake City, Utah.
Alfred K. Cheung, Division of Nephrology and Hypertension, University of Utah Health, Salt Lake City, Utah.
Dominic S. Raj, Division of Renal Diseases and Hypertension, George Washington University School of Medicine and Health Sciences, Washington, DC.
Linda F. Fried, Division of Nephrology, University of Pittsburgh School of Medicine, Pittsburgh, PA.
Stuart Sprague, Department of Medicine, NorthShore University HealthSystem, Evanston, IL.
Geoffrey Block, US Renal Care, Dallas, TX.
Michel Chonchol, Department of Medicine, Division of Renal Diseases and Hypertension, University of Colorado Denver School of Medicine, Aurora, CO.
John Paul Middleton, Department of Medicine, Division of Nephrology, Duke University School of Medicine, Durham, NC.
Myles Wolf, Department of Medicine, Division of Nephrology, Duke University School of Medicine, Durham, NC.
Joachim H. Ix, Department of Medicine, Renal Section, University of California San Diego School of Medicine, San Diego, CA.
Pottumarthi Prasad, Department of Radiology, NorthShore University HealthSystem, Evanston, IL.
Tamara Isakova, Division of Nephrology and Hypertension, Center for Translational Metabolism and Health, Institute for Public Health and Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL.
Anand Srivastava, Division of Nephrology and Hypertension, Center for Translational Metabolism and Health, Institute for Public Health and Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL.

Document Type

Journal Article

Publication Date

4-4-2024

Journal

Kidney360

DOI

10.34067/KID.0000000000000437

Abstract

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 interleukin-6 (IL-6) and C-reactive protein (CRP) in 127 participants from the COMBINE trial, a randomized, 12-month trial of nicotinamide and lanthanum carbonate vs. 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/1.73m2, 1.46±0.17 x10-3 mm2/s, and 20.3±3.1 s-1, respectively. Median [IQR] IL-6 and CRP were 3.7 [2.4-4.9] pg/mL and 2.8 [1.2-6.3] mg/L. After multivariable adjustment, IL-6 and CRP were 13.1% and 27.3% higher per 1 SD decrease in baseline cortical ADC. 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.

Department

Medicine

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