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Blood Oxygen Level–Dependent (BOLD) MRI in Renovascular Hypertension

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Abstract

Establishing whether large vessel occlusive disease threatens tissue oxygenation and viability in the post-stenotic kidney is difficult for clinicians. Development of blood oxygen level–dependent (BOLD) MRI methods can allow functional evaluation of regional differences in deoxyhemoglobin levels within the kidney without requiring contrast. The complex renal circulation normally provides a gradient of oxygenation from a highly vascular cortex to much reduced levels in the deep sections of medulla, dependent upon adjustments in renal afferent arterioles, oxygen consumption related to solute transport, and arteriovenous shunting related to the juxtaposition of descending and ascending vasa recta. Studies with BOLD imaging have identified adaptation to substantial reductions in renal blood flow, volume, and glomerular filtration rate in post-stenotic kidneys that preserves medullary and cortical oxygenation during medical therapy. However, extreme vascular compromise overwhelms these adaptive changes and leads to cortical hypoxia and microvascular injury.

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Acknowledgments

The projects described were supported by Award Number PO1HL85307 from the National Heart, Lung and Blood Institute and NIH/NCRR CTSA Grant Number UL1 RR024150. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Heart, Lung, and Blood Institute or the National Institutes of Health.

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No potential conflicts of interest relevant to this article were reported.

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Authors and Affiliations

  1. Division of Nephrology and Hypertension, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA

    Monika L. Gloviczki, Lilach O. Lerman & Stephen C. Textor

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  1. Monika L. Gloviczki
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  2. Lilach O. Lerman
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  3. Stephen C. Textor
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Correspondence to Stephen C. Textor.

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Gloviczki, M.L., Lerman, L.O. & Textor, S.C. Blood Oxygen Level–Dependent (BOLD) MRI in Renovascular Hypertension. Curr Hypertens Rep 13, 370–377 (2011). https://doi.org/10.1007/s11906-011-0218-7

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