{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T22:56:52Z","timestamp":1787785012670,"version":"build-2784847793"},"reference-count":31,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2026,1,31]],"date-time":"2026-01-31T00:00:00Z","timestamp":1769817600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background\/Objectives: Early identification of vasculitic acute kidney injury (AKI) is crucial for timely immunosuppression and improved renal outcomes; however, noninvasive adjunctive diagnostic tools remain limited. Renal elastography, a noninvasive technique that quantifies renal cortical stiffness, has been primarily investigated in chronic kidney disease, whereas evidence in acute kidney injury is scarce. This study aimed to evaluate the diagnostic utility of renal shear wave elastography for differentiating vasculitic from non-vasculitic AKI and to explore the association between baseline renal cortical stiffness and vasculitic renal outcomes. Materials and Methods: This prospective observational study included three groups: vasculitic AKI, non-vasculitic AKI, and healthy controls. Renal cortical stiffness was measured at admission using two-dimensional shear-wave elastography (2D-SWE) by radiologists blinded to clinical information. After clinicopathological confirmation of definitive diagnoses, between-group comparisons were performed and the diagnostic performance of elastography was evaluated. Additionally, in a biopsy-confirmed immunoglobulin A vasculitis nephritis (IgAVN) cohort (n = 12), baseline elastography measurements were examined in relation to one-year renal outcomes to explore potential prognostic associations. Results: The vasculitic AKI group exhibited significantly higher mean renal cortical stiffness values (9.5 \u00b1 1.9 kPa) compared with both healthy controls (5.53 \u00b1 0.92 kPa) and the non-vasculitic AKI group (6.61 \u00b1 1.89 kPa) (both p &lt; 0.01). Mean renal cortical stiffness demonstrated good diagnostic performance for distinguishing vasculitic from non-vasculitic AKI (AUC 0.86, 95% CI 0.73\u20130.97), with an optimal threshold of 6.79 kPa yielding 91% sensitivity and 72% specificity. In the prospective one-year follow-up of the IgAVN subcohort (n = 12), patients with unfavorable renal outcomes tended to have higher baseline renal cortical stiffness compared with those with favorable outcomes [median (min\u2013max), 11.2 (10.8\u201313.3) vs. 9.1 (5.6\u201311.2), p = 0.046]. Conclusions: These findings suggest that renal elastography may aid in distinguishing vasculitic from non-vasculitic acute kidney injury and may provide exploratory information on the relationship between baseline cortical stiffness and renal outcomes in IgAVN.<\/jats:p>","DOI":"10.3390\/jcm15031122","type":"journal-article","created":{"date-parts":[[2026,2,2]],"date-time":"2026-02-02T09:00:33Z","timestamp":1770022833000},"page":"1122","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Renal Shear Wave Elastography for Differentiating Vasculitic and Non-Vasculitic Acute Kidney Injury"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3909-7500","authenticated-orcid":false,"given":"Fatih","family":"Y\u0131ld\u0131r\u0131m","sequence":"first","affiliation":[{"name":"Department of Rheumatology, Ba\u015fak\u015fehir \u00c7am and Sakura City Hospital, University of Health Sciences, 34480 \u0130stanbul, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samet","family":"Mutlu","sequence":"additional","affiliation":[{"name":"Department of Radiology, Ba\u015fak\u015fehir \u00c7am and Sakura City Hospital, University of Health Sciences, 34480 \u0130stanbul, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Merve","family":"Sam Ozdemir","sequence":"additional","affiliation":[{"name":"Department of Radiology, Ba\u015fak\u015fehir \u00c7am and Sakura City Hospital, University of Health Sciences, 34480 \u0130stanbul, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Melek","family":"Yalcin Mutlu","sequence":"additional","affiliation":[{"name":"Department of Medicine 3-Rheumatology and Immunology, Friedrich-Alexander-Universit\u00e4t Erlangen-N\u00fcrnberg and Uniklinikum Erlangen, 91054 Erlangen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0804-3198","authenticated-orcid":false,"given":"Alp","family":"Temiz","sequence":"additional","affiliation":[{"name":"Department of Medicine 3-Rheumatology and Immunology, Friedrich-Alexander-Universit\u00e4t Erlangen-N\u00fcrnberg and Uniklinikum Erlangen, 91054 Erlangen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1111-3110","authenticated-orcid":false,"given":"Sena","family":"Tolu","sequence":"additional","affiliation":[{"name":"Department of PMR, Medipol University School of Medicine, 34214 \u0130stanbul, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2133-0282","authenticated-orcid":false,"given":"Gamze","family":"Akkuzu","sequence":"additional","affiliation":[{"name":"Department of Rheumatology, Ba\u015fak\u015fehir \u00c7am and Sakura City Hospital, University of Health Sciences, 34480 \u0130stanbul, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1294-926X","authenticated-orcid":false,"given":"Duygu","family":"Sevinc Ozgur","sequence":"additional","affiliation":[{"name":"Department of Rheumatology, Ba\u015fak\u015fehir \u00c7am and Sakura City Hospital, University of Health Sciences, 34480 \u0130stanbul, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bilgin","family":"Karaalioglu","sequence":"additional","affiliation":[{"name":"Department of Rheumatology, Ba\u015fak\u015fehir \u00c7am and Sakura City Hospital, University of Health Sciences, 34480 \u0130stanbul, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rabia","family":"Deniz","sequence":"additional","affiliation":[{"name":"Department of Rheumatology, Ba\u015fak\u015fehir \u00c7am and Sakura City Hospital, University of Health Sciences, 34480 \u0130stanbul, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G\u00fcrsel","family":"Y\u0131ld\u0131z","sequence":"additional","affiliation":[{"name":"Department of Nephrology, Ba\u015fak\u015fehir \u00c7am and Sakura City Hospital, University of Health Sciences, 34480 \u0130stanbul, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cemal","family":"Bes","sequence":"additional","affiliation":[{"name":"Department of Rheumatology, Ba\u015fak\u015fehir \u00c7am and Sakura City Hospital, University of Health Sciences, 34480 \u0130stanbul, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,1,31]]},"reference":[{"key":"ref_1","unstructured":"National Institute for Health and Care Excellence (NICE) (2026, January 27). 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