Magnetic resonance imaging to assess fibrosis in chronic kidney disease

Chronic kidney disease (CKD) is a major public health problem. Accumulating evidence suggests that a key contributor to the progression of nearly all forms of CKD is fibrosis. Multiple physical changes occur in the fibrotic kidney, such as 1) reduced capillary density, 2) dilated and atrophic tubules, 3) increased interstitial extracellular matrix, and 4) hypoxia. Although meaningful in the initial diagnostic assessment, renal biopsy remains an imperfect test for fibrosis measurement. The limitation is not only by its invasiveness, but also, for its sampling bias. Recent advances in imaging technology have raised the exciting possibility of using magnetic resonance imaging (MRI) for the study of tissue oxygen levels, microcirculation abnormality, tubular loss and the “kidney stiffening”. These new MRI-based techniques may provide potential noninvasive and accurate measurements for fibrosis in CKD.