Diagnostic of chronic kidney disease and renal transplant pathologies through the direct and kidney-wide mapping of microvascular anomalies with sensing-volumetric Ultrasound Localization Microscopy

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Chronic kidney disease (CKD) is a major global health issue, with peripheral kidney microvascular damage being a hallmark feature that is challenging to assess and often requires renal transplant. Current diagnostic methods for monitoring microvascular complications in renal grafts, such as biopsies, lack the practicality needed for regular assessment. Ultrasound localization microscopy (ULM) and sensing-ULM (sULM) present a promising approach, providing detailed metrics on the microvascular network. We have demonstrated that sULM can visualize glomeruli in a patient's kidney in 2D by observing the peculiar swirling behavior of clinically common microbubbles within them. Such a technique could be used to characterize the kidney's microcirculation and its modifications by pathologies like CKD, but was severely impaired by its planar character. A sensing-volumetric-ULM, 3D, technique could transform renal transplant management by offering a non-invasive, portable solution to monitor vascular health and detect early graft dysfunction in entire kidneys at the microscale. This innovation builds on the ERC Cog ResolveStroke and ERC POC StrokeMonitor projects. The KidneyScope project, combining volumetric ULM and this glomerular insight, represents a promising approach to address the urgent need for high-resolution renal microcirculation assessment.