Renal Parenchymal Area and Kidney Collagen Content

TL;DR

This study introduces a noninvasive method to estimate renal parenchymal area from ultrasound measurements, which correlates strongly with collagen content, a marker of renal scarring, potentially reducing the need for invasive biopsies in CKD assessment.

Contribution

A novel technique for estimating renal parenchymal area using two simple measurements that accurately reflect kidney collagen content and scarring.

Findings

Renal parenchymal area can be estimated accurately with a new elliptical model.

Calculated area strongly correlates with biochemical collagen measurements.

Method enables noninvasive assessment of renal scarring.

Abstract

The extent of renal scarring in chronic kidney disease (CKD) can only be ascertained by highly invasive, painful and sometimes risky tissue biopsy. Interestingly, CKD-related abnormalities in kidney size can often be visualized using ultrasound. Nevertheless, not only does the ellipsoid formula used today underestimate true renal size but also the relation governing renal size and collagen content remains unclear. We used coronal kidney sections from healthy mice and mice with renal disease to develop a new technique for estimating the renal parenchymal area. While treating the kidney as an ellipse with the major axis the polar distance, this technique involves extending the minor axis into the renal pelvis. The calculated renal parenchymal area is remarkably similar to the measured area. Biochemically determined kidney collagen content revealed a strong and positive correlation with the calculated renal parenchymal area. The extent of renal scarring, i.e. kidney collagen content, can now be computed by making just two renal axial measurements which can easily be accomplished via noninvasive imaging of this organ.