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Original

Effect of dark chocolate on renal tissue oxygenation as measured by BOLD-MRI in healthy volunteers

Menno Pruijm, Lucie Hofmann, Julie Charollais-Thoenig, Valentina Forni, Marc Maillard, Andrew Coristine, Matthias Stuber, Michel Burnier and Bruno Vogt

Volume 80 (2013) p. 211 - 217

Abstract

Clinical Nephrology, Vol. 80 – No. 3/2013 (211-217)

Effect of dark chocolate on renal tissue oxygenation as measured by BOLD-MRI in healthy volunteers

Menno Pruijm¹, Lucie Hofmann¹, Julie Charollais-Thoenig¹, Valentina Forni¹, Marc Maillard¹, Andrew Coristine², Matthias Stuber², Michel Burnier¹ and Bruno Vogt¹

¹Department of Nephrology and ²Department of Radiology, University Hospital of Lausanne (CHUV), Switzerland
Background: Cocoa is rich in flavonoids, has anti-oxidative properties and increases the bioavailability of nitric oxide (NO). Adequate renal tissue oxygenation is crucial for the maintenance of renal function. The goal of this study was to investigate the effect of cocoa-rich dark chocolate (DC) on renal tissue oxygenation in humans, as compared to flavonoid-poor white chocolate (WC). Methods: Ten healthy volunteers with preserved kidney function (mean age ± SD 35 ± 12 years, 70% women, BMI 21 ± 3 kg/m2) underwent blood oxygenation level-dependent magnetic resonance imaging (BOLD-MRI) before and 2 hours after the ingestion of 1 g/kg of DC (70% cocoa). Renal tissue oxygenation was determined by the measurement of R2* maps on 4 coronal slices covering both kidneys. The mean R2* (= 1/T2*) values in the medulla and cortex were calculated, a low R2* indicating high tissue oxygenation. Eight participants also underwent BOLD-MRI at least 1 week later, before and 2 hours after the intake of 1 g/kg WC. Results: The mean medullary R2* was lower after DC intake compared to baseline (28.2 ± 1.3 s–1 vs. 29.6 ± 1.3 s–1, p = 0.04), whereas cortical and medullary R2* values did not change after WC intake. The change in medullary R2* correlated with the level of circulating (epi)catechines, metabolites of flavonoids (r = 0.74, p = 0.037), and was independent of plasma renin activity. Conclusion: This study suggests for the first time an increase of renal medullary oxygenation after intake of dark chocolate. Whether this is linked to flavonoid-induced changes in renal perfusion or oxygen consumption, and whether cocoa has potentially renoprotective properties, merits further study.Correspondence to:
Dr. Menno Pruijm
Division of Nephrology and Hypertension
Consultation Centre Hospitalier Universitaire Vaudois
Rue du Bugnon 17, 1011 Lausanne, Switzerland
Email: [email protected]

Nephrology Education

Does spontaneous remission occur in polyarteritis nodosa? 

Simon Beyaert, Menno Pruijm, Salah Qanadli, Peter Vollenweider, Matthieu Halfon

Volume 87 (2017) p. 255 - 260

Abstract

Clinical Nephrology, Vol. 87 – No. 5/2017 (255-260)

Does spontaneous remission occur in polyarteritis nodosa? 

Simon Beyaert¹, Menno Pruijm², Salah Qanadli³, Peter Vollenweider⁴, Matthieu Halfon² 

¹Université Catholique de Louvain, Louvain, Belgium, ²Nephrology and Hypertension Unit, University Hospital of Lausanne, ³Cardio-Thoracic and Vascular Unit, Department of Radiology, University Hospital of Lausanne, and ⁴Internal Medicine Department, University Hospital of Lausanne, Lausanne, Switzerland
Background: Polyarteritis nodosa (PAN) is a systemic vasculitis involving mainly medium-sized arteries and, rarely, small-sized arteries. The diagnosis is principally based on clinical exams, biopsy of an affected organ, and/or arteriography of renal or mesenteric arteries. Once diagnosed, immunosuppressive agents, such as glucocorticoids and cyclophosphamide, are generally introduced as soon as possible. Whether spontaneous remission of PAN occurs is therefore largely unknown. Presentation: We describe the case of a 51-year-old woman who presented with a 4-day-history of intense pain in her left flank, hypertension, fever, microscopic hematuria, and acute renal failure. Contrast-enhanced renal ultrasound strongly suggested bilateral renal infarction. Medical history and an extensive workup allowed to exclude systemic embolism, recreational drug abuse, cardiac arrhythmias, and thrombophilia. A possible diagnosis of PAN was considered; however, within 2 weeks of admission, spontaneous remission of her clinical and biological symptoms occurred without the use of any immunosuppressive treatment. Finally, 3 months later, renal arteriography confirmed the diagnosis of PAN. The patient remains free of symptoms 1 year after initial presentation. Conclusion: This case illustrates the importance of considering PAN in the differential diagnosis of renal infarction with inflammatory syndrome and shows that spontaneous remission of renal PAN can occur. Correspondence to:
Dr. Matthieu Halfon 
Service of Nephrology and Hypertension
University Hospital of Lausanne (CHUV)
Rue du Bugnon 17, 1011 Lausanne, Switzerland 
Email: [email protected]

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