Multimodal Imaging Assessment of Chronic Kidney Disease Patients at Different Stages From a Cardio-Renal Interaction Perspective

The Affiliated Hospital of Qingdao University60 enrolled

Overview

This study is a prospective cohort investigation in which consecutive eligible patients undergo 18F-FAPI PET/MR imaging. Chronic kidney disease (CKD) participants are stratified into two groups:Group I ：CKD stages 1-3（eGFR ≥ 30 mL/min/1.73 m²）,Group II :CKD stages 4-5(eGFR \< 30 mL/min/1.73 m²). Using 18F-FAPI PET/MR, we will evaluate global cardiac functional impairment and myocardial fibrosis characteristics, and analyze their associations with the degree of renal dysfunction.

Study Type

OBSERVATIONAL

Enrollment

Conditions

Chronic Kidney Disease Cardiac Magnetic Resonance 18F-FAPI

Interventions

18F PET/MROTHER

Tracer: \^18F FAPI 04 is used in this study. A single intravenous bolus dose of 3.70-4.44 MBq/kg is administered. • Simultaneous PET/MR Acquisition: During PET imaging, cardiac MR (CMR) is performed in the supine position. All images are acquired with ECG gating and respiratory gating, during end expiratory breath holds. 1. Cardiac Morphology and Function (Localization \& Cine):Assess cardiac structure and global/regional function 2. T2 Weighted Fat Suppressed Imaging:Evaluate myocardial edema 3. First Pass Perfusion Imaging:Quantitatively assess the extent and severity of myocardial perfusion defects 4. Late Gadolinium Enhancement (LGE): Detect and quantify myocardial necrosis and fibrosis 5. T1 Mapping (Pre and Post Contrast): Quantify myocardial interstitial fibrosis 6. T2 Mapping (Pre Contrast):Quantify myocardial edema 7. Cardiac PET Imaging:Evaluate myocardial fibrosis characteristics using \^18F FAPI PET data

Eligibility

Sex: ALLMin age: 18 YearsMax age: 80 Years

Medical Language ↔ Plain English

Inclusion Criteria: 1. Age between 18 and 80 years, regardless of sex. 2. Clinically diagnosed with chronic kidney disease (CKD), based on KDIGO guidelines. 3. Complete clinical data available. 4. Written informed consent for participation and for undergoing 18F-FAPI PET/MR imaging is obtained from the patient or their legal guardian. 5. Female participants must agree to use effective contraception during the study and for at least 6 months after its completion (e.g., sterilization, intrauterine hormonal devices, condoms, hormonal contraceptives, abstinence, or vasectomized partner). Male participants must also agree to use contraception during the study and for 6 months after its completion. Exclusion Criteria: 1. Women who are planning to conceive, currently pregnant, or breastfeeding. 2. Contraindications to PET/MR imaging, including but not limited to metal implants, claustrophobia, or inability to tolerate cardiac MRI due to respiratory difficulties. 3. History of allergy or hypersensitivity to gadolinium-based contrast agents. 4. Presence of malignant tumors or other serious progressive diseases. 5. Patients with severe cardiac conditions, such as advanced heart failure, severe valvular disease, or cardiomyopathies. 6. Hemodynamic instability. 7. Presence of severe systemic or localized infections, or other serious comorbid conditions. 8. Incomplete clinical data. 9. Any other reason deemed by the investigators to make the subject unsuitable for participation, including inability or unwillingness to comply with study procedures and requirements. 10. Determined by the investigators to be inappropriate for inclusion in the study.

Outcomes

Primary Outcomes

Myocardial fibrosis burden measured by 18F-FAPI PET/MR

Myocardial uptake of 18F-FAPI quantified using SUVmax and SUVmean values from PET imaging.

Time frame: At baseline (within 1 week of enrollment)