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Functional magnetic resonance imaging for staging chronic kidney disease: a systematic review and meta-analysis

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Abstract

Introduction

The commonly used clinical indicators are not sensitive and comprehensive enough to evaluate the early staging of chronic kidney disease (CKD). This study aimed to evaluate the differences in arterial spin labeling (ASL) and blood oxygenation level–dependent functional magnetic resonance imaging (BOLD-MRI) parameter values among patients at various stages of chronic kidney disease and healthy individuals.

Methods

Electronic databases PubMed, Web of Science, Cochrane, and Embase were searched from inception to March 29, 2024, to identify relevant studies on ASL and BOLD in CKD. The renal blood flow (RBF) and apparent relaxation rate (R2*) values were obtained from healthy individuals and patients with various stages of CKD. The meta-analysis was conducted using STATA version 12.0. The random-effects model was used to obtain estimates of the effects, and the results were expressed as 95% confidence intervals (CIs) and mean differences (MDs) of continuous variables.

Results

A total of 18 published studies were included in this meta-analysis. The cortical RBF and R2* values and medulla RBF values were considerably distinct between patients with various stages of CKD and healthy controls (MD, − 78.162; 95% CI, − 85.103 to − 71.221; MD, 2.440; 95% CI, 1.843 to 3.037; and MD, − 36.787; 95% CI, − 47.107 to − 26.468, respectively). No obvious difference in medulla R2* values was noted between patients with various stages of CKD and healthy controls (MD, − 1.475; 95% CI, − 4.646 to 1.696).

Conclusion

ASL and BOLD may provide complementary and distinct information regarding renal function and could potentially be used together to gain a more comprehensive understanding of renal physiology.

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Data availability

Additional data are made available in supplementary document of this manuscript.

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Acknowledgements

The authors would like to acknowledge Professor Jinhui Tian from the Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University for his guidance on the methodology. The funders had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication.

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This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

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Authors and Affiliations

  1. First Clinical School of Medicine, Gansu University of Chinese Medicine, Lanzhou, China

    Lian Qiu Xiong, Li Li Ma, Liu Yan Shi, Ni Ni Pan, Jian Xin Zhao & Di Liang He

  2. Philip Healthcare, Xi’an, China

    Kai Ai

  3. Department of Radiology, Gansu Provincial Hospital, Lanzhou, 730000, China

    Gang Hang

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Xiong, L.Q., Ma, L.L., Shi, L.Y. et al. Functional magnetic resonance imaging for staging chronic kidney disease: a systematic review and meta-analysis. Int Urol Nephrol (2024). https://doi.org/10.1007/s11255-024-04055-z

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