Association between kidney intracapsular pressure and ultrasound elastography

Kianoush B. Kashani, Shennen A. Mao, Sami Safadi, Bruce P. Amiot, Jaime M. Glorioso, John C Lieske, Scott Nyberg, Xiaoming Zhang

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Background: Kidney congestion is a common pathophysiologic pathway of acute kidney injury (AKI) in sepsis and heart failure. There is no noninvasive tool to measure kidney intracapsular pressure (KIP) directly. Methods: We evaluated the correlation of KIP with kidney elasticity measured by ultrasound surface wave elastography (USWE). We directly measured transcatheter KIP in three pigs at baseline and after bolus infusion of normal saline, norepinephrine, vasopressin, dopamine, and fenoldopam; infiltration of 2-L peritoneal dialysis solution in the intra-abdominal space; and venous, arterial, and ureteral clamping. KIP was compared with USWE wave speed. Results: Only intra-abdominal installation of peritoneal dialysis fluid was associated with significant change in KIP (mean (95% CI) increase, 3.7 (3.2-4.2)] mmHg; P < .001). Although intraperitoneal pressure and KIP did not differ under any experimental condition, bladder pressure was consistently and significantly greater than KIP under all circumstances (mean (95% CI) bladder pressure vs. KIP, 3.8 (2.9-4.) mmHg; P < .001). USWE wave speed significantly correlated with KIP (adjusted coefficient of determination, 0.71; P < .001). Estimate (95% CI) USWE speed for KIP prediction stayed significant after adjustment for KIP hypertension (-0.8 (- 1.4 to - 0.2) m/s; P = .008) whereas systolic and diastolic blood pressures were not significant predictors of KIP. Conclusions: In a pilot study of the swine model, we found ultrasound surface wave elastography speed is significantly correlated with transcatheter measurement of kidney intracapsular and intra-abdominal pressures, while bladder pressure overestimated kidney intracapsular pressure.

Original languageEnglish (US)
JournalCritical Care
Volume21
Issue number1
DOIs
StatePublished - Oct 19 2017

Fingerprint

Elasticity Imaging Techniques
Kidney
Pressure
Urinary Bladder
Peritoneal Dialysis
Swine
Fenoldopam
Blood Pressure

Keywords

  • Acute kidney injury
  • Bladder pressure
  • Intra-abdominal hypertension
  • Kidney intracapsular pressure
  • Swine model
  • Ultrasound surface wave elastography

ASJC Scopus subject areas

  • Critical Care and Intensive Care Medicine

Cite this

Association between kidney intracapsular pressure and ultrasound elastography. / Kashani, Kianoush B.; Mao, Shennen A.; Safadi, Sami; Amiot, Bruce P.; Glorioso, Jaime M.; Lieske, John C; Nyberg, Scott; Zhang, Xiaoming.

In: Critical Care, Vol. 21, No. 1, 19.10.2017.

Research output: Contribution to journalArticle

Kashani, Kianoush B. ; Mao, Shennen A. ; Safadi, Sami ; Amiot, Bruce P. ; Glorioso, Jaime M. ; Lieske, John C ; Nyberg, Scott ; Zhang, Xiaoming. / Association between kidney intracapsular pressure and ultrasound elastography. In: Critical Care. 2017 ; Vol. 21, No. 1.
@article{7540d5e02cb5437c9de6f9a244c92f28,
title = "Association between kidney intracapsular pressure and ultrasound elastography",
abstract = "Background: Kidney congestion is a common pathophysiologic pathway of acute kidney injury (AKI) in sepsis and heart failure. There is no noninvasive tool to measure kidney intracapsular pressure (KIP) directly. Methods: We evaluated the correlation of KIP with kidney elasticity measured by ultrasound surface wave elastography (USWE). We directly measured transcatheter KIP in three pigs at baseline and after bolus infusion of normal saline, norepinephrine, vasopressin, dopamine, and fenoldopam; infiltration of 2-L peritoneal dialysis solution in the intra-abdominal space; and venous, arterial, and ureteral clamping. KIP was compared with USWE wave speed. Results: Only intra-abdominal installation of peritoneal dialysis fluid was associated with significant change in KIP (mean (95{\%} CI) increase, 3.7 (3.2-4.2)] mmHg; P < .001). Although intraperitoneal pressure and KIP did not differ under any experimental condition, bladder pressure was consistently and significantly greater than KIP under all circumstances (mean (95{\%} CI) bladder pressure vs. KIP, 3.8 (2.9-4.) mmHg; P < .001). USWE wave speed significantly correlated with KIP (adjusted coefficient of determination, 0.71; P < .001). Estimate (95{\%} CI) USWE speed for KIP prediction stayed significant after adjustment for KIP hypertension (-0.8 (- 1.4 to - 0.2) m/s; P = .008) whereas systolic and diastolic blood pressures were not significant predictors of KIP. Conclusions: In a pilot study of the swine model, we found ultrasound surface wave elastography speed is significantly correlated with transcatheter measurement of kidney intracapsular and intra-abdominal pressures, while bladder pressure overestimated kidney intracapsular pressure.",
keywords = "Acute kidney injury, Bladder pressure, Intra-abdominal hypertension, Kidney intracapsular pressure, Swine model, Ultrasound surface wave elastography",
author = "Kashani, {Kianoush B.} and Mao, {Shennen A.} and Sami Safadi and Amiot, {Bruce P.} and Glorioso, {Jaime M.} and Lieske, {John C} and Scott Nyberg and Xiaoming Zhang",
year = "2017",
month = "10",
day = "19",
doi = "10.1186/s13054-017-1847-2",
language = "English (US)",
volume = "21",
journal = "Critical Care",
issn = "1364-8535",
publisher = "BioMed Central Ltd.",
number = "1",

}

TY - JOUR

T1 - Association between kidney intracapsular pressure and ultrasound elastography

AU - Kashani, Kianoush B.

AU - Mao, Shennen A.

AU - Safadi, Sami

AU - Amiot, Bruce P.

AU - Glorioso, Jaime M.

AU - Lieske, John C

AU - Nyberg, Scott

AU - Zhang, Xiaoming

PY - 2017/10/19

Y1 - 2017/10/19

N2 - Background: Kidney congestion is a common pathophysiologic pathway of acute kidney injury (AKI) in sepsis and heart failure. There is no noninvasive tool to measure kidney intracapsular pressure (KIP) directly. Methods: We evaluated the correlation of KIP with kidney elasticity measured by ultrasound surface wave elastography (USWE). We directly measured transcatheter KIP in three pigs at baseline and after bolus infusion of normal saline, norepinephrine, vasopressin, dopamine, and fenoldopam; infiltration of 2-L peritoneal dialysis solution in the intra-abdominal space; and venous, arterial, and ureteral clamping. KIP was compared with USWE wave speed. Results: Only intra-abdominal installation of peritoneal dialysis fluid was associated with significant change in KIP (mean (95% CI) increase, 3.7 (3.2-4.2)] mmHg; P < .001). Although intraperitoneal pressure and KIP did not differ under any experimental condition, bladder pressure was consistently and significantly greater than KIP under all circumstances (mean (95% CI) bladder pressure vs. KIP, 3.8 (2.9-4.) mmHg; P < .001). USWE wave speed significantly correlated with KIP (adjusted coefficient of determination, 0.71; P < .001). Estimate (95% CI) USWE speed for KIP prediction stayed significant after adjustment for KIP hypertension (-0.8 (- 1.4 to - 0.2) m/s; P = .008) whereas systolic and diastolic blood pressures were not significant predictors of KIP. Conclusions: In a pilot study of the swine model, we found ultrasound surface wave elastography speed is significantly correlated with transcatheter measurement of kidney intracapsular and intra-abdominal pressures, while bladder pressure overestimated kidney intracapsular pressure.

AB - Background: Kidney congestion is a common pathophysiologic pathway of acute kidney injury (AKI) in sepsis and heart failure. There is no noninvasive tool to measure kidney intracapsular pressure (KIP) directly. Methods: We evaluated the correlation of KIP with kidney elasticity measured by ultrasound surface wave elastography (USWE). We directly measured transcatheter KIP in three pigs at baseline and after bolus infusion of normal saline, norepinephrine, vasopressin, dopamine, and fenoldopam; infiltration of 2-L peritoneal dialysis solution in the intra-abdominal space; and venous, arterial, and ureteral clamping. KIP was compared with USWE wave speed. Results: Only intra-abdominal installation of peritoneal dialysis fluid was associated with significant change in KIP (mean (95% CI) increase, 3.7 (3.2-4.2)] mmHg; P < .001). Although intraperitoneal pressure and KIP did not differ under any experimental condition, bladder pressure was consistently and significantly greater than KIP under all circumstances (mean (95% CI) bladder pressure vs. KIP, 3.8 (2.9-4.) mmHg; P < .001). USWE wave speed significantly correlated with KIP (adjusted coefficient of determination, 0.71; P < .001). Estimate (95% CI) USWE speed for KIP prediction stayed significant after adjustment for KIP hypertension (-0.8 (- 1.4 to - 0.2) m/s; P = .008) whereas systolic and diastolic blood pressures were not significant predictors of KIP. Conclusions: In a pilot study of the swine model, we found ultrasound surface wave elastography speed is significantly correlated with transcatheter measurement of kidney intracapsular and intra-abdominal pressures, while bladder pressure overestimated kidney intracapsular pressure.

KW - Acute kidney injury

KW - Bladder pressure

KW - Intra-abdominal hypertension

KW - Kidney intracapsular pressure

KW - Swine model

KW - Ultrasound surface wave elastography

UR - http://www.scopus.com/inward/record.url?scp=85031704069&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85031704069&partnerID=8YFLogxK

U2 - 10.1186/s13054-017-1847-2

DO - 10.1186/s13054-017-1847-2

M3 - Article

C2 - 29047410

AN - SCOPUS:85031704069

VL - 21

JO - Critical Care

JF - Critical Care

SN - 1364-8535

IS - 1

ER -