ArticleQuantitative imaging in medicine and surgery2026
Renal R2* as a noninvasive predictor of hepatorenal syndrome-acute kidney disease in cirrhotic patients with ascites: a retrospective cohort study.
Article in Quantitative imaging in medicine and surgery, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Hepatorenal syndrome-acute kidney disease (HRS-AKD) is associated with poor renal outcomes in cirrhotic patients, yet no established noninvasive imaging marker exists for its early prediction. This study evaluated renal R2* derived from magnetic resonance elastography (MRE) with multi-echo R2* mapping as a noninvasive imaging marker for predicting the development of HRS-AKD in cirrhotic patients with ascites. Methods: This retrospective observational study analyzed 376 patients who underwent liver MRE with multi-echo R2* mapping between January 2018 and October 2024. Median renal R2* values were quantified from the left kidney using radiomics-based analysis. HRS-AKD was defined as an estimated glomerular filtration rate (eGFR) <60 mL/min/1.73 m Results: Among cirrhotic patients with ascites, 12.9% developed HRS-AKD; 62.5% had a prior episode of HRS-acute kidney injury (AKI). Median renal R2* was higher in patients who developed HRS-AKD (P=0.007), and inversely correlated with eGFR measured at MRE (r=-0.34, P=0.006). Renal R2* did not correlate with serum iron markers or hemoglobin (all P≥0.05). The area under the receiver operating characteristic curve (AUROC) of renal R2* was 74.5 [95% confidence interval (CI): 57.4-91.6] for predicting HRS-AKD, outperforming liver stiffness and serum fibrosis markers. An R2* cut-off of 20.8 s Conclusions: Renal R2* is a promising noninvasive imaging marker candidate for predicting the development of HRS-AKD in cirrhotic patients with ascites.
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