Assessment of renal perfusion impairment in a rat model of acute renal congestion using contrast-enhanced ultrasonography
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Renal congestion is caused by elevated central venous pressure (CVP), and decreases glomerular filtration in patients with congestive heart failure. Since real-time contrast-enhanced ultrasonography (CEUS) using microbubble-based contrast agents can visualize the perfused microvascular bed, we sought to evaluate the impairment of renal perfusion during acute renal congestion with CEUS. In Wister rats, CEUS of kidney was performed with the direct monitoring of CVP and intra-renal pressure (IRP). When CVP was elevated to 10 and 15 mmHg after the bolus injection of normal saline via the femoral vein, peak intensity (PI, dB) and time to PI (TTP) in the renal cortex and medulla were compared with control rats. There was a strong correlation between IRP and CVP (r = 0.95, p < 0.0001). In the congestion model, more time was required for enhancement of the parenchyma, especially in the medulla compared to control; TTP of the medulla and cortex at 15 mmHg CVP (CVP15) was significantly prolonged compared with controls (medulla, 4351 ± 98 vs. 1415 ± 267 ms, p = 0.003; cortex, 3219 ± 106 vs. 1335 ± 264 ms, p = 0.005). In addition, medullary PI at CVP15 decreased, but not significantly, compared to those of controls and at 10 mmHg CVP (20.1 ± 0.9, 22.8 ± 1.6, 21.6 ± 0.2 dB). In contrast, cortical PIs at CVP15 were significantly lower than that of control (24.6 ± 1.0 vs. 31.4 ± 1.0 dB, p = 0.007). CEUS revealed that impaired renal parenchymal flow in an acute congestion model is accompanied with increased renal interstitial pressure.
KeywordsRenal congestion Congestive heart failure Contrast-enhanced ultrasonography Central venous pressure
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Conflict of interest
There are no financial or other relationships that could lead to a conflict of interest.
- 9.Fischer T, Filimonow S, Dieckhöfer J, Slowinski T, Mühler M, Lembcke A, Budde K, Neumayer HH, Ebeling V, Giessing M, Thomas A, Morgera S (2006) Improved diagnosis of early kidney allograft dysfunction by ultrasound with echo enhancer—a new method for the diagnosis of renal perfusion. Nephrol Dial Transplant 21(10):2921–2929CrossRefPubMedGoogle Scholar
- 10.Ciccone MM, Cortese F, Fiorella A, Scicchitano P, Cito F, Quistelli G, Pertosa G, D’Agostino R, Guida P, Favale S (2011) The clinical role of contrast-enhanced ultrasound in the evaluation of renal artery stenosis and diagnostic superiority as compared to traditional echo-color-Doppler flow imaging. Int Angiol 30:135–139PubMedGoogle Scholar
- 13.Garber J, Barbee R, Bielitzki J, Clayton LA, Donovan J, Hendriksen C, Kohn D, Lipman N, Locke P, Melcher J, Quimby F, Turner P, Wood G, Wurbel H (2008) Guide for the care and use of laboratory animals, 8th edn. National Academy Press, Washington, DC, pp 1–220Google Scholar
- 15.Wakui N, Takayama R, Kamiyama N, Kobayashi K, Matsui D, Matsukiyo Y, Kanekawa T, Ikehara T, Ishii K, Sumino Y (2013) Arrival time parametric imaging using Sonazoid-enhanced ultrasonography is useful for the detection of spoke-wheel patterns of focal nodular hyperplasia smaller than 3 cm. Exp Ther Med 5(6):1551–1554CrossRefPubMedPubMedCentralGoogle Scholar