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Arterial spin labeling (ASL) MRI enables noninvasive perfusion quantification but is highly susceptible to respiratory motion artifacts in renal applications. In this work, we developed and validated a free\u2010breathing renal ASL technique using flow\u2010sensitive alternating inversion recovery with golden\u2010angle radial sampling and motion\u2010corrected reconstruction. Eleven healthy volunteers (25\u2009\u00b1\u20092.1\u2009years, six male) and nine Stage 2 chronic kidney disease (CKD) patients (42\u2009\u00b1\u200917\u2009years) were enrolled. Healthy subjects underwent repeat scans after a 1\u2010week interval for test\u2013retest assessment. A breath\u2010hold turbo spin\u2010echo ASL sequence served as the reference. Renal blood flow (RBF) in the cortex and medulla was quantified using the Buxton model. The proposed free\u2010breathing approach showed strong agreement with the breath\u2010hold reference (coefficient of variation [CoV]\u2009=\u20098.8%) and excellent scan\u2013rescan repeatability (CoV\u2009=\u20097.7%). Mean bias between free\u2010breathing and breath\u2010hold RBF measurements was 13\u2009\u00b1\u200921\u2009mL\/100\u2009g\/min (\n                    <jats:italic>p<\/jats:italic>\n                    \u2009&lt;\u20090.001). In healthy volunteers, cortical RBF was 249\u2009\u00b1\u200919\u2009mL\/100\u2009g\/min and medullary RBF 138\u2009\u00b1\u200920\u2009mL\/100\u2009g\/min; in CKD patients, these values were significantly reduced to 144\u2009\u00b1\u200934 and 75\u2009\u00b1\u200915\u2009mL\/100\u2009g\/min, respectively (\n                    <jats:italic>p<\/jats:italic>\n                    \u2009&lt;\u20090.001). This free\u2010breathing ASL technique provides a reliable and repeatable foundation for RBF assessment that does not require breath\u2010holding, facilitating broader clinical applicability particularly in patients with limited respiratory capacity, and offers potential for investigating renal pathophysiology.\n                  <\/jats:p>","DOI":"10.1002\/nbm.70397","type":"journal-article","created":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T00:26:37Z","timestamp":1789431997000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Free\u2010Breathing Arterial Spin Labeling MRI of the Kidney Using Flow\u2010Sensitive\u2010Alternating Inversion Recovery With Golden\u2010Angle Radial Sampling"],"prefix":"10.1002","volume":"39","author":[{"ORCID":"https:\/\/orcid.org\/0009-0005-5112-1720","authenticated-orcid":false,"given":"Yizhe","family":"Zhang","sequence":"first","affiliation":[{"name":"School of Biomedical Engineering Southern Medical University  Guangzhou China"},{"name":"Guangdong Provincial Key Laboratory of Medical Image Processing &amp; Guangdong Province Engineering Laboratory for Medical Imaging and Diagnostic Technology Southern Medical University  Guangzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wenyan","family":"Zhang","sequence":"additional","affiliation":[{"name":"School of Biomedical Engineering Southern Medical University  Guangzhou China"},{"name":"Guangdong Provincial Key Laboratory of Medical Image Processing &amp; Guangdong Province Engineering Laboratory for Medical Imaging and Diagnostic Technology Southern Medical University  Guangzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Songsong","family":"Sun","sequence":"additional","affiliation":[{"name":"School of Biomedical Engineering Southern Medical University  Guangzhou China"},{"name":"Guangdong Provincial Key Laboratory of Medical Image Processing &amp; Guangdong Province Engineering Laboratory for Medical Imaging and Diagnostic Technology Southern Medical University  Guangzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Caixia","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Medical Imaging Center, Nanfang Hospital Southern Medical University  Guangzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jianping","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Medical Imaging Center, Nanfang Hospital Southern Medical University  Guangzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0564-0325","authenticated-orcid":false,"given":"Peng","family":"Wu","sequence":"additional","affiliation":[{"name":"Philips Healthcare  Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Di","family":"Xie","sequence":"additional","affiliation":[{"name":"Division of Nephrology, Nanfang Hospital Southern Medical University  Guangzhou China"},{"name":"National Clinical Research Center for Kidney Disease  Guangzhou China"},{"name":"State Key Laboratory of Multi\u2010Organ Injury Prevention and Treatment  Guangzhou China"},{"name":"Guangdong Provincial Institute of Nephrology  Guangzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7584-6527","authenticated-orcid":false,"given":"Thoralf","family":"Niendorf","sequence":"additional","affiliation":[{"name":"Berlin Ultrahigh Field Facility (B.U.F.F.) Max Delbruck Center for Molecular Medicine in the Helmholtz Association  Berlin Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Quan","family":"Tao","sequence":"additional","affiliation":[{"name":"School of Biomedical Engineering Southern Medical University  Guangzhou China"},{"name":"Guangdong Provincial Key Laboratory of Medical Image Processing &amp; Guangdong Province Engineering Laboratory for Medical Imaging and Diagnostic Technology Southern Medical University  Guangzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zelong","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Medical Imaging Center, Nanfang Hospital Southern Medical University  Guangzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2807-5974","authenticated-orcid":false,"given":"Yanqiu","family":"Feng","sequence":"additional","affiliation":[{"name":"School of Biomedical Engineering Southern Medical University  Guangzhou China"},{"name":"Guangdong Provincial Key Laboratory of Medical Image Processing &amp; Guangdong Province Engineering Laboratory for Medical Imaging and Diagnostic Technology Southern Medical University  Guangzhou China"},{"name":"State Key Laboratory of Multi\u2010Organ Injury Prevention and Treatment  Guangzhou China"},{"name":"Guangdong\u2010Hong Kong\u2010Macao Greater Bay Area Center for Brain Science and Brain\u2010Inspired Intelligence  Guangzhou China"},{"name":"Key Laboratory of Mental Health of the Ministry of Education  Guangzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,9,14]]},"reference":[{"key":"e_1_2_17_2_1","first-page":"307","volume-title":"Guyton and Hall Textbook of Medical Physiology","author":"Hall J. 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