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Comparative Study
. 2015 Jul;88(1):146-51.
doi: 10.1038/ki.2015.71. Epub 2015 Apr 1.

A comparison of ultrasound and magnetic resonance imaging shows that kidney length predicts chronic kidney disease in autosomal dominant polycystic kidney disease

Harpreet Bhutani  1 , Vikram Smith  1 , Frederic Rahbari-Oskoui  1 , Ankush Mittal  1 , Jared J Grantham  2 , Vicente E Torres  3 , Michal Mrug  4 , Kyongtae T Bae  5 , Zhiyuan Wu  5 , Yinghui Ge  5 , Doug Landslittel  5 , Patrice Gibbs  5 , W Charles O'Neill  1 , Arlene B Chapman  1 ; CRISP Investigators
Affiliations
Comparative Study

A comparison of ultrasound and magnetic resonance imaging shows that kidney length predicts chronic kidney disease in autosomal dominant polycystic kidney disease

Harpreet Bhutani et al. Kidney Int. 2015 Jul.

Abstract

Autosomal dominant polycystic kidney disease (ADPKD) is marked by gradual renal cyst and kidney enlargement and ultimately renal failure. Magnetic resonance-based, height-adjusted total kidney volume (htTKV) over 600 cc/m predicts the development of CKD stage 3 within 8 years in the Consortium for Radiologic Imaging in Polycystic Kidney Disease cohort. Here we compared simultaneous ultrasound and magnetic resonance imaging to determine whether ultrasound and kidney length (KL) predict future CKD stage 3 over longer periods of follow-up. A total of 241 ADPKD patients, 15-46 years, with creatinine clearance of 70 ml/min and above had iothalamate clearance, magnetic resonance, and ultrasound evaluations. Participants underwent an average of five repeat clearance measurements over a mean follow-up of 9.3 years. Ultrasound and magnetic resonance-based TKV and KL were compared using Bland-Altman plots and intraclass correlations. Each measure was tested to predict future CKD stage 3. Relatively strong intraclass correlations between ultrasound and magnetic resonance were found for both htTKV and KL (0.81 and 0.85, respectively). Ultrasound and magnetic resonance-based htTKV and KL predicted future CKD stage 3 similarly (AUC of 0.87, 0.88, 0.87, and 0.88, respectively). An ultrasound kidney length over 16.5 cm and htTKV over 650 ml/min had the best cut point for predicting the development of CKD stage 3. Thus, kidney length alone is sufficient to stratify the risk of progression to renal insufficiency early in ADPKD using either ultrasound or magnetic resonance imaging.

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Figures

Fig 1
Fig 1
(a–d): Bland-Altman plots comparing MR and US kidney length for right (a) and left kidneys (b) in 234 CRISP participants and in those with kidney length < 17 cm for right (c) and left (d) kidneys. 2SD of agreement are provided in shaded interval.
Fig 1
Fig 1
(a–d): Bland-Altman plots comparing MR and US kidney length for right (a) and left kidneys (b) in 234 CRISP participants and in those with kidney length < 17 cm for right (c) and left (d) kidneys. 2SD of agreement are provided in shaded interval.
Fig 1
Fig 1
(a–d): Bland-Altman plots comparing MR and US kidney length for right (a) and left kidneys (b) in 234 CRISP participants and in those with kidney length < 17 cm for right (c) and left (d) kidneys. 2SD of agreement are provided in shaded interval.
Fig 1
Fig 1
(a–d): Bland-Altman plots comparing MR and US kidney length for right (a) and left kidneys (b) in 234 CRISP participants and in those with kidney length < 17 cm for right (c) and left (d) kidneys. 2SD of agreement are provided in shaded interval.
Fig 2
Fig 2
(a–b): Scatterplots of MR and US kidney length for right (a) and left (b) kidneys in 234 CRISP participants.
Fig 2
Fig 2
(a–b): Scatterplots of MR and US kidney length for right (a) and left (b) kidneys in 234 CRISP participants.
Figure 3
Figure 3
ROC curve predicting CKD stage 3a comparing MR and US based length along with MR and US based htTKV.
See this image and copyright information in PMC

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References

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