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Renal ultrafiltration changes induced by focused US
Institution:
 1Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Focused Ultrasound Laboratory, 221 Longwood Ave, Room 515, Boston, MA 02215, USA. kfischer@bwh.harvard.edu
22nd Department of Pathology, Semmelweis University, Budapest, Hungary.
31st Department of Pediatrics, Semmelweis University, Budapest, Hungary.
Publisher:
 Radiology
Publication Date:
 Dec-2009
Volume Number:
 253
Issue Number:
 3
Pages:
 577-578
Citation:
 Radiology. 2009 Dec;253(3):577-8.
PubMed ID:
 19703861
PMCID:
 PMC2786196
Keywords:
 glomenular filtration rate (GFR)
Appears in Collections:
NCIGT, FUS
Sponsors:
 NIH U41 RR019703
NIH P01 CA067165
Generated Citation:
 Fischer K., McDannold N.J., Zhang Y., Kardos M., Szabo A., Szabo A., Reusz G.S., Jolesz F.A. Renal ultrafiltration changes induced by focused US. Radiology. 2009 Dec;253(3):577-8. PMID: 19703861. PMCID: PMC2786196.
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PURPOSE: To determine if focused ultrasonography (US) combined with a diagnostic microbubble-based US contrast agent can be used to modulate glomerular ultrafiltration and size selectivity. MATERIALS AND METHODS: The experiments were approved by the animal care committee. The left kidney of 17 healthy rabbits was sonicated by using a 260-kHz focused US transducer in the presence of a microbubble-based US contrast agent. The right kidney served as the control. Three acoustic power levels were applied: 0.4 W (six rabbits), 0.9 W (six rabbits), and 1.7 W (five rabbits). Three rabbits were not treated with focused US and served as control animals. The authors evaluated changes in glomerular size selectivity by measuring the clearance rates of 3000- and 70,000-Da fluorescence-neutral dextrans. The creatinine clearance was calculated for estimation of the glomerular filtration rate. The urinary protein-creatinine ratio was monitored during the experiments. The authors assessed tubular function by evaluating the fractional sodium excretion, tubular reabsorption of phosphate, and gamma-glutamyltransferase-creatinine ratio. Whole-kidney histologic analysis was performed. For each measurement, the values obtained before and after sonication were compared by using the paired t test. RESULTS: Significant (P < .05) increases in the relative (ratio of treated kidney value/nontreated kidney value) clearance of small- and large-molecule agents and the urine flow rates that resulted from the focused US treatments were observed. Overall, 1.23-, 1.23-, 1.61-, and 1.47-fold enhancement of creatinine clearance, 3000-Da dextran clearance, 70 000-Da dextran clearance, and urine flow rate, respectively, were observed. Focal tubular hemorrhage and transient functional tubular alterations were observed at only the highest (1.7-W) acoustic power level tested. CONCLUSION: Glomerular ultrafiltration and size selectivity can be temporarily modified with simultaneous application of US and microbubbles. This method could offer new opportunities for treatment of renal disease.

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