Öz
Objective: Quantitative measurement of renal parenchymal lipid accumulation in chronic renal disease using chemical shift magnetic resonance imaging and evaluation of its relationship with clinical stages.
Material and Methods: In this retrospective study, the groups were designed as in chronic renal disease (n=46), diabetes without chronic renal disease (n=31), and control (n=59). Chronic renal disease group also divided into two subgroups as diabetic chronic renal disease (n=25) and non-diabetic chronic renal disease (n=21). A total of 272 kidneys of 136 patients were evaluated. Chronic renal disease clinical staging was performed according to e-GFR values. All magnetic resonance imaging examinations were performed with a 1.5 Tesla device. Chemical shift imaging was used in this study to quantify fat in the renal parenchyma (in-phase, out-of-phase, Dixon-water and Dixon-fat). Measurements were made from kidney and spleen by two different methods as whole parenchyma (first method) and focal parenchymal (second method). The fat fraction, and spleen-to-renal chemical shift imaging ratio were calculated.
Results: In the control group, parenchymal fat fraction according to first and second measurement methods were calculated as 0.05±0.01 and 0.05 ± 0.02, respectively. In the chronic renal disease groups, fat fraction measurements were 0.07±0.02 and 0.07±0.04, respectively, and they were found to be significantly higher from chronic renal disease stage 3 compared to the control group (p<0.001). No significant difference was observed in fat fraction and spleen-to-renal chemical shift imaging ratio values in diabetes patients (p>0.05).
Conclusion: In chronic renal disease, starting from stage 3, there is a significant renal parenchymal lipid accumulation compared to the control group and diabetic patients.
Teşekkür
We are grateful to Uğur Toprak (Professor, Department Radiology, Faculty of Medicine, Osmangazi University, Eskişehir), Ozgur Pirgon (Professor, Department of Pediatric Endocrinology and Diabetes, Faculty of Medicine, S.Demirel University, Isparta), and Murat Korkmaz (Professor, Department of Gastroenterology, Faculty of Medicine, Istinye University, Istanbul) for careful reading of the manuscript and helpful comments and suggestions.