To investigate the association of renal elasticity to microscopic findings of nephron hypertrophy and nephrosclerosis.
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.
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).
Renal elasticity was correlated with microstructural findings of nephron hypertrophy. Measuring renal elasticity could help in detecting kidney disease.
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National Kidney Foundation. K/DOQI clinical practice guidelines for chronic kidney disease. Evaluation, classification, and stratification. Am J Kidney Dis. 2002;39:S1–266.
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.
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.
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.
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.
Sarvazyan AP, Urban MW, Greenleaf JF. Acoustic waves in medical imaging and diagnosis. Ultrasound Med Biol. 2013;39:1133–46.
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.
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.
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.
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.
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).
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
Mora-Fernández C, Domínguez-Pimentel V, de Fuentes MM, et al. Diabetic kidney disease: from physiology to therapeutics. J Physiol. 2014;592:3997–4012.
Denic A, Glassock RJ, Rule AD. Structural and functional changes with the aging kidney. Adv Chronic Kidney Dis. 2016;23:19–28.
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.
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All authors declare that they have no conflicts of interest.
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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