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MRI Offers Advancements in Treatment for Chronic Kidney Disease

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Scientists at The University of Nottingham have recently constructed detailed structural and functional 'maps' of the human kidney made using advanced scanning technology.

The research, funded with £107,623 from the Dr Hadwen Trust, a non-animal biomedical research charity, aims to further expand medical understanding on how the kidneys operate, with the main goal of leading to better monitoring and treatment for chronic kidney disease.

The study will be the very first of its kind to employ magnetic resonance imaging to examine the role which oxygen plays in keeping the human kidney healthy.

The study, headed led by Dr Sue Francis from the University's Sir Peter Mansfield Magnetic Resonance Centre and is in collaboration with Professor Chris McIntyre from the University's School of Medicine.

"Current tests for chronic kidney disease can be very invasive and patients may need to return to the hospital on a number of occasions. The aim of this project is to produce a set of non-invasive measurements that we can produce in a single, one-hour scanning session that can assess the blood flow and oxygenation of the kidney and which could eventually be rolled out in a clinical setting to benefit patients,” said Francis.

The kidneys play a crucial role in the human body, sifting waste products from the blood before changing them to urine. They also help to maintain blood pressure, regulate chemical levels in the body, keep bones healthy by producing a type of vitamin D, and stimulate the production of red blood cells.

However, health conditions such as diabetes and high blood pressure can have a tremendous impact on how efficiently the kidneys can operate and can lead to chronic kidney disease, causing tiredness, water retention, weight loss, and a loss of appetite.kidney disease

As of today, the disease is diagnosed by a blood test which measures the GFR, glomerular filtration rate, which is the quantity of blood that is filtered through the kidneys. In more serious kidney conditions, a renal biopsy may need to be performed, which involves removing a small sample of tissue from the kidney.

“Current methods can only offer a fairly crude picture of what is happening in the kidneys and how that is changing over time. For example, if one kidney is doing most of the work it can be difficult to tell and taking just a small sample of tissue from one area of the kidney may not be representative of the organ as a whole,” noted Francis.

The research will instead employ magnetic resonance imaging (MRI), powered by a 3 Tesla magnet, to scan the kidney and construct a detailed picture of perfusion in the kidney, the manner in which blood is transported to and flows through the organ. Additionally, it will measure the metabolic rate of oxygen, how oxygen is consumed within the kidney, which has not been done before using MR imaging.

The research aims to develop novel MRI methods, and utilize these methods in healthy volunteers to document and study the kidney's response to oxygen and CO2 changes to evaluate how the kidney behaves under stress which mimics diseased kidneys.

For the next phase of the study, the researchers will scan 20 patients with diabetic nephropathy (kidney disease caused by diabetes) in a proposal to prove the effectiveness of their techniques. The scanning technique could be used to track the progression of a patient's disease and to observe the effect and effectiveness of drugs being used to treat the condition.

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