Skip to main content
SpringerLink
Log in

Renal shear wave elastography for the assessment of nephron hypertrophy: a cross-sectional study in chronic kidney disease

Journal of Medical Ultrasonics volume 45, pages 571–576 (2018)Cite this article

Abstract

Purpose

To investigate the association of renal elasticity to microscopic findings of nephron hypertrophy and nephrosclerosis.

Methods

Patients who underwent renal biopsy were enrolled. Renal elasticity was measured by acoustic radiation force impulse, and nephron size (glomerular volume, non-sclerotic glomerular density, and mean profile tubular area) and nephrosclerosis (globally sclerotic glomeruli and interstitial fibrosis) were estimated. Nephron hypertrophy was indicated by larger glomerular volume, larger tubular area, and lower non-sclerotic glomerular density. Nephrosclerosis was indicated by a higher percentage of globally sclerotic glomeruli and higher severity of fibrosis.

Results

Renal elasticity was negatively correlated with glomerular volume (r = − 0.480, P = 0.024) and mean tubular area (r = − 0.469, P = 0.028), but it was not correlated with non-sclerotic glomerular density (r = 0.205, P = 0.359), percentage of globally sclerotic glomeruli (r = 0.057, P = 0.800), and severity of fibrosis (r = 0.014, P = 0.950). In a multiple linear regression analysis, glomerular volume and mean tubular area were independently associated with renal elasticity (std β = − 0.454, P = 0.015 and std β = − 0.577, P = 0.007, respectively).

Conclusion

Renal elasticity was correlated with microstructural findings of nephron hypertrophy. Measuring renal elasticity could help in detecting kidney disease.

This is a preview of subscription content, access via your institution.

Access options

Buy single article

Instant access to the full article PDF.

USD 39.95

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. National Kidney Foundation. K/DOQI clinical practice guidelines for chronic kidney disease. Evaluation, classification, and stratification. Am J Kidney Dis. 2002;39:S1–266.

    Google Scholar 

  2. Muntner P, Judd SE, McClellan W, et al. Incidence of stroke symptoms among adults with chronic kidney disease: results from the Reasons for Geographic And Racial Differences in Stroke (REGARDS) study. Nephrol Dial Transplant. 2012;27:166–73.

    Article  CAS  Google Scholar 

  3. Imai E, Horio M, Yamagata K, et al. Slower decline of glomerular filtration rate in the Japanese general population: a longitudinal 10-year follow-up study. Hypertens Res. 2008;31:433–41.

    Article  Google Scholar 

  4. Elsherbiny HE, Alexander MP, Kremers WK, et al. Nephron hypertrophy and glomerulosclerosis and their association with kidney function and risk factors among living kidney donors. Clin J Am Soc Nephrol. 2014;9:1892–902.

    Article  CAS  Google Scholar 

  5. Metcalfe W. How does early chronic kidney disease progress? A background paper prepared for the UK Consensus Conference on early chronic kidney disease. Nephrol Dial Transplant. 2007;Suppl 9:ix 26–30.

    Google Scholar 

  6. Sarvazyan AP, Urban MW, Greenleaf JF. Acoustic waves in medical imaging and diagnosis. Ultrasound Med Biol. 2013;39:1133–46.

    Article  Google Scholar 

  7. Lupsor M, Badea R, Stefanescu H, et al. Performance of a new elastographic method (ARFI technology) compared to unidimensional transient elastography in the noninvasive assessment of chronic hepatitis C preliminary results. J Gastrointest Liver Dis. 2009;18:303–10.

    Google Scholar 

  8. Takahashi H, Ono N, Eguchi Y, et al. Evaluation of acoustic radiation force impulse elastography for fibrosis staging of chronic liver disease: a pilot study. Liver Int. 2010;30:538–45.

    Article  Google Scholar 

  9. Cui G, Yang Z, Zhang W, et al. Evaluation of acoustic radiation force impulse imaging for the clinicopathological typing of renal fibrosis. Exp Ther Med. 2014;7:233–5.

    Article  Google Scholar 

  10. Stock KF, Klein BS, Vo Cong MT, et al. ARFI-based tissue elasticity quantification in comparison to histology for the diagnosis of renal transplant fibrosis. Clin Hemorheol Microcirc. 2010;46:139–48.

    CAS  PubMed  Google Scholar 

  11. Japanese Society of Nephrology. Clinical practice guidebook for diagnosis and treatment of chronic kidney disease 2012. Nihon Jinzo Gakkai Shi. 2012;54:1034–191 (in Japanese).

    Google Scholar 

  12. Takata T, Koda M, Sugihara T, et al. Renal shear wave velocity by acoustic radiation force impulse did not reflect advanced renal impairment. Nephrology (Carlton). 2016;21:1056–62.

    Article  Google Scholar 

  13. Denic A, Alexander MP, Kaushik V, et al. Detection and clinical patterns of nephron hypertrophy and nephrosclerosis among apparently healthy adults. Am J Kidney Dis. 2016;68:58–67.

    Article  Google Scholar 

  14. Syversveen T, Brabrand K, Midtvedt K, et al. Assessment of renal allograft fibrosis by acoustic radiation force impulse quantification—a pilot study. Transpl Int. 2011;24:100–5.

    Article  Google Scholar 

  15. Grenier N, Poulain S, Lepreux S, et al. Quantitative elastography of renal transplants using supersonic shear imaging: a pilot study. Eur Radiol. 2012;22:2138–46.

    Article  Google Scholar 

  16. Wang L, Xia P, Lv K, et al. Assessment of renal tissue elasticity by acoustic radiation force impulse quantification with histopathological correlation: preliminary experience in chronic kidney disease. Eur Radiol. 2014;24:1694–9.

    Article  Google Scholar 

  17. Guo LH, Xu HX, Fu HJ, et al. Acoustic radiation force impulse imaging for noninvasive evaluation of renal parenchyma elasticity: preliminary findings. PLoS One. 2013;11:e68925.

    Article  Google Scholar 

  18. Zhou XJ, Fenves AZ, Vaziri ND, et al. Renal changes with aging and end-stage renal disease. In: Jennette J, Olson JL, Silva FG, D’Agati VD, editors. Heptinstall’s pathology of the kidney. 7th ed. Philadelphia: Wolters Kluwer; 2015. p. 1297–305.

    Google Scholar 

  19. Bruno C, Minniti S, Bucci A, et al. ARFI: from basic principles to clinical applications in diffuse chronic disease—a review. Insights Imaging. 2016;7:735–46.

    Article  Google Scholar 

  20. Gallotti A, D’Onofrio M, Pozzi Mucelli R. Acoustic radiation force impulse (ARFI) technique in ultrasound with virtual touch tissue quantification of the upper abdomen. Radiol Med. 2010;115:889–97.

    Article  CAS  Google Scholar 

  21. Tobar A, Ori Y, Benchetrit S, et al. Proximal tubular hypertrophy and enlarged glomerular and proximal tubular urinary space in obese subjects with proteinuria. PLoS One. 2013;8:e75547.

    Article  CAS  Google Scholar 

  22. Thomson SC, Deng A, Bao D, et al. Ornithine decarboxylase, kidney size, and the tubular hypothesis of glomerular hyperfiltration in experimental diabetes. J Clin Investig. 2001;107:217–24.

    Article  CAS  Google Scholar 

  23. Mora-Fernández C, Domínguez-Pimentel V, de Fuentes MM, et al. Diabetic kidney disease: from physiology to therapeutics. J Physiol. 2014;592:3997–4012.

    Article  Google Scholar 

  24. Denic A, Glassock RJ, Rule AD. Structural and functional changes with the aging kidney. Adv Chronic Kidney Dis. 2016;23:19–28.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Division of Medicine and Clinical Science, Department of Multidisciplinary Internal Medicine, Tottori University, 36-1 Nishimachi, Yonago, Tottori, 683-8504, Japan

    Takuji Iyama, Tomoaki Takata, Masahiko Koda, Satoko Fukuda, Shotaro Hoi, Yukari Mae, Takeaki Fukui, Chishio Munemura & Hajime Isomoto

Authors
  1. Takuji Iyama
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Tomoaki Takata
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Masahiko Koda
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Satoko Fukuda
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Shotaro Hoi
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Yukari Mae
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Takeaki Fukui
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Chishio Munemura
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Hajime Isomoto
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Tomoaki Takata.

Ethics declarations

Ethical statements

All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1964 and later versions. Informed consent was obtained from all patients for being included in the study.

Conflict of interest

All authors declare that they have no conflicts of interest.

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Iyama, T., Takata, T., Koda, M. et al. Renal shear wave elastography for the assessment of nephron hypertrophy: a cross-sectional study in chronic kidney disease. J Med Ultrasonics 45, 571–576 (2018). https://doi.org/10.1007/s10396-018-0866-1

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10396-018-0866-1

Keywords

search

Navigation