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Increased renal cortical stiffness obtained by share-wave elastography imaging significantly predicts the contrast-induced nephropathy in patients with preserved renal function

  • Hilmi Erdem SumbulEmail author
  • Ayse Selcan Koc
  • Derya Demirtas
  • Hasan Koca
  • Burcak Cakir Pekoz
  • Feride Fatma Gorgulu
  • Yurdaer Donmez
  • Abdullah Orhan Demirtas
  • Mevlut Koc
  • Yahya Kemal Icen
Original Article

Abstract

Purpose

We aimed to investigate the relation between renal cortical stiffness (CS) obtained by shear-wave elastography (SWE) and contrast-induced nephropathy (CIN) development in interventional treatment-planned acute coronary syndrome (ACS) patients.

Methods

Our study group consisted of 465 ACS patients. Routine laboratory assessments, B-mode, Doppler, and SWE renal ultrasonography (USG) evaluations were performed. Renal resistive index (RRI), renal pulsatility index (RPI), and acceleration time (AT) and CS were measured. Patients were grouped as with and without CIN.

Results

Among the study group, 55 patients (11.8%) had CIN. Age, diabetes mellitus (DM), hypertension (HT), basal creatinine, CK-MB and troponin I levels, contrast volume, contrast volume/weight ratio, SYNTAX score, RRI, RPI, AT, and CS values were significantly higher in patients with CIN. eGFR was lower in patients who developed CIN. Age, contrast volume/weight ratio, and CS were determined as independent predictors of CIN occurrence in logistic regression analysis. In multivariate logistic analysis, increase of age (each year), contrast volume/weight (each 0.2 mL/kg), and CS (each 1 kPa) were found to augment the development of CIN by 7.1, 59.5, and 62.3%, respectively. In the ROC analysis, CS had the highest AUROC value. The cutoff value of CS obtained by the ROC curve analysis was 7 kPa for the CIN development (sensitivity: 74.5%, specificity: 72.5%).

Conclusion

CS value is a simple, cheap, reproducible, noninvasive, and objective parameter for the detection of CIN development. ACS patients should be directed to renal USG, and routine CS value should be written besides USG measurements in reports.

Keywords

Cortical stiffness Shear-wave elastography Contrast-induced nephropathy Acute coronary syndrome 

Notes

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical statement

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individuals who participated in the study.

References

  1. 1.
    Gurm HS, Seth M, Kooiman J, Share D (2013) A novel tool for reliable and accurate prediction of renal complications in patients undergoing percutaneous coronary intervention. J Am Coll Cardiol 61:2242–2248CrossRefGoogle Scholar
  2. 2.
    Narula A, Mehran R, Weisz G, Dangas GD, Yu J, Généreux P et al (2014) Contrast-induced acute kidney injury after primary percutaneous coronary intervention: results from the HORIZONS-AMI substudy. Eur Heart J 35:1533–1540CrossRefGoogle Scholar
  3. 3.
    Wybraniec MT, Chudek J, Bożentowicz-Wikarek M, Mizia-Stec K (2017) Prediction of contrast-induced acute kidney injury by early post-procedural analysis of urinary biomarkers and intra-renal Doppler flow indices in patients undergoing coronary angiography. J Interv Cardiol 30:465–472CrossRefGoogle Scholar
  4. 4.
    Wybraniec MT, Bożentowicz-Wikarek M, Chudek J, Mizia-Stec K (2017) Pre-procedural renal resistive index accurately predicts contrast-induced acute kidney injury in patients with preserved renal function submitted to coronary angiography. Int J Cardiovasc Imaging 33:595–604CrossRefGoogle Scholar
  5. 5.
    Lerolle N (2012) Please don’t call me RI anymore; I may not be the one you think I am! Crit Care 16:174CrossRefGoogle Scholar
  6. 6.
    Lerolle N, Guérot E, Faisy C, Bornstain C, Diehl JL, Fagon JY (2006) Renal failure in septic shock: predictive value of Doppler-based renal arterial resistive index. Intensive Care Med 32:1553–1559CrossRefGoogle Scholar
  7. 7.
    Tublin ME, Bude RO, Platt JF (2003) Review: The resistive index in renal Doppler sonography: where do we stand? Am J Roentgenol 180:885–892CrossRefGoogle Scholar
  8. 8.
    Darmon M, Schortgen F, Leon R, Moutereau S, Mayaux J, Di Marco F et al (2009) Impact of mild hypoxemia on renal function and renal resistive index during mechanical ventilation. Intensive Care Med 35:1031–1038CrossRefGoogle Scholar
  9. 9.
    Ponte B, Pruijm M, Ackermann D, Vuistiner P, Eisenberger U, Guessous I et al (2014) Reference values and factors associated with renal resistive index in a family-based population study. Hypertension 63:136–142CrossRefGoogle Scholar
  10. 10.
    O’Rourke MF, Safar ME (2005) Relationship between aortic stiffening and microvascular disease in brain and kidney: cause and logic of therapy. Hypertension 46:200–204CrossRefGoogle Scholar
  11. 11.
    Watanabe S, Okura T, Kurata M, Irita J, Manabe S, Miyoshi K et al (2006) Valsartan reduces serum cystatin C and the renal vascular resistance in patients with essential hypertension. Clin Exp Hypertens 28:451–461CrossRefGoogle Scholar
  12. 12.
    Zaffanello M, Piacentini G, Bruno C, Brugnara M, Fanos V (2015) Renal elasticity quantification by acoustic radiation force impulse applied to the evaluation of kidney diseases: a review. J Investig Med 63:605–612CrossRefGoogle Scholar
  13. 13.
    Samir AE, Allegretti AS, Zhu Q, Dhyani M, Anvari A, Sullivan DA et al (2015) Shear wave elastography in chronic kidney disease: a pilot experience in native kidneys. BMC Nephrol 116:119CrossRefGoogle Scholar
  14. 14.
    Goya C, Kilinc F, Hamidi C, Yavuz A, Yildirim Y, Cetincakmak MG et al (2015) Acoustic radiation force impulse imaging for evaluation of renal parenchyma elasticity in diabetic nephropathy. Am J Roentgenol 204:324–329CrossRefGoogle Scholar
  15. 15.
    Marticorena Garcia SR, Grossmann M, Lang ST, Tzschätzsch H, Dittmann F, Hamm B et al (2018) Tomoelastography of the native kidney: regional variation and physiological effects on in vivo renal stiffness. Magn Reson Med 79:2126–2134CrossRefGoogle Scholar
  16. 16.
    Hassan K, Loberant N, Abbas N, Fadi H, Shadia H, Khazim K (2016) Shear wave elastography imaging for assessing the chronic pathologic changes in advanced diabetic kidney disease. Ther Clin Risk Manag 12:1615–1622CrossRefGoogle Scholar
  17. 17.
    Sommerer C, Scharf M, Seitz C, Millonig G, Seitz HK, Zeier M et al (2013) Assessment of renal allograft fibrosis by transient elastography. Transpl Int 26:545–551CrossRefGoogle Scholar
  18. 18.
    Arndt R, Schmidt S, Loddenkemper C, Grünbaum M, Zidek W, van der Giet M et al (2010) Noninvasive evaluation of renal allograft fbrosis by transient elastography—a pilot study. Transpl Int 23:871–877Google Scholar
  19. 19.
    Mehta RL, Kellum JA, Shah SV, Molitoris BA, Ronco C, Warnock DG et al (2007) Acute kidney injury network: report of an initiative to improve outcomes in acute kidney injury. Crit Care 11:R31CrossRefGoogle Scholar
  20. 20.
    Rihal CS, Textor SC, Grill DE, Berger PB, Ting HH, Best PJ et al (2002) Incidence and prognostic importance of acute renal failure after percutaneous coronary intervention. Circulation 105:2259–2264CrossRefGoogle Scholar
  21. 21.
    Mehran R, Aymong ED, Nikolsky E, Lasic Z, Iakovou I, Fahy M et al (2004) A simple risk score for prediction of contrast-induced nephropathy after percutaneous coronary intervention: development and initial validation. J Am Coll Cardiol 44:1393–1399Google Scholar
  22. 22.
    Gurm HS, Seth M, Kooiman J, Share D (2013) A novel tool for reliable and accurate prediction of renal complications in patients undergoing percutaneous coronary intervention. J Am Coll Cardiol 61:2242–2248CrossRefGoogle Scholar
  23. 23.
    Tziakas D, Chalikias G, Stakos D, Altun A, Sivri N, Yetkin E et al (2014) Validation of a new risk score to predict contrast-induced nephropathy after percutaneous coronary intervention. Am J Cardiol 113:1487–1493CrossRefGoogle Scholar
  24. 24.
    Schnell D, Deruddre S, Harrois A, Pottecher J, Cosson C, Adoui N et al (2012) Renal resistive index better predicts the occurrence of acute kidney injury than cystatin C. Shock 38:592–597CrossRefGoogle Scholar
  25. 25.
    Winther SO, Thiesson HC, Poulsen LN, Chehri M, Agerskov H, Tepel M (2012) The renal arterial resistive index and stage of chronic kidney disease in patients with renal allograft. PLoS One 7:e51772CrossRefGoogle Scholar
  26. 26.
    Ninet S, Schnell D, Dewitte A, Zeni F, Meziani F, Darmon M (2015) Doppler-based renal resistive index for prediction of renal dysfunction reversibility: a systematic review and meta-analysis. J Crit Care 30:629–635CrossRefGoogle Scholar
  27. 27.
    Grenier N, Gennisson JL, Cornelis F, Le Bras Y, Couzi L (2013) Renal ultrasound elastography. Diagn Interv Imaging 94:545–550CrossRefGoogle Scholar
  28. 28.
    Quintavalle C, Fiore D, De Micco F, Visconti G, Focaccio A, Golia B et al (2012) Impact of a high loading dose of atorvastatin on contrast-induced acute kidney injury. Circulation 126:3008–3016CrossRefGoogle Scholar
  29. 29.
    Koc AS, Sumbul HE (2018) Renal cortical stiffness obtained by shear wave elastography imaging is increased in patients with type 2 diabetes mellitus without diabetic nephropathy. J Ultrasound 21(4):279–285.  https://doi.org/10.1007/s40477-018-0315-4 Epub 2018 Jul 26 CrossRefGoogle Scholar
  30. 30.
    Spatola L (2016) Andrulli S (2016) Doppler ultrasound in kidney diseases: a key parameter in clinical long-term follow-up. J Ultrasound 19(4):243–250CrossRefGoogle Scholar

Copyright information

© Società Italiana di Ultrasonologia in Medicina e Biologia (SIUMB) 2019

Authors and Affiliations

  • Hilmi Erdem Sumbul
    • 1
    Email author
  • Ayse Selcan Koc
    • 2
  • Derya Demirtas
    • 1
  • Hasan Koca
    • 3
  • Burcak Cakir Pekoz
    • 2
  • Feride Fatma Gorgulu
    • 2
  • Yurdaer Donmez
    • 3
  • Abdullah Orhan Demirtas
    • 3
  • Mevlut Koc
    • 3
  • Yahya Kemal Icen
    • 3
  1. 1.Department of Internal MedicineUniversity of Health Sciences - Adana Health Practice and Research CenterAdanaTurkey
  2. 2.Department of RadiologyUniversity of Health Sciences - Adana Health Practice and Research CenterAdanaTurkey
  3. 3.Department of CardiologyUniversity of Health Sciences - Adana Health Practice and Research CenterAdanaTurkey

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