Objective To evaluate renal function and structural changes in chronic kidney disease(CKD)based on blood oxygenation level dependent imaging(BOLD),diffusion weighted imaging(DWI),and diffusion tensor imaging(DTI)based on a meta-analysis.Methods Literature databases were searched from PubMed,Cochrane Library,Embase,China Knowledge Network,and Wan-fang Medical to identify relevant articles involving the use of BOLD,DWI,and DTI in patients with CKD between January 2010 and December 2020.The R2*,apparent diffusion coefficient(ADC),and fractional anisotropy(FA)val-ues were extracted from the healthy control subjects and patients with different stages of CKD.All results were summarized and analyzed by Stata 16.0 software.Results Twenty-two studies were included.In sum-mary,the BOLD cortical R2* values for the CKD group,mild and severe sub-groups were significantly higher than the healthy control subjects.The weighted mean differences(WMD)were 1.26(95%CI 0.54-1.98,P<0.01),1.25(95%CI 0.50-2.01,P<0.01),and 2.19(95%CI 0.63-3.75,P<0.01),respectively.The cortical R2* value of the severe sub-group was significantly higher than the mild sub-group(WMD=1.43,95%CI 0.05-2.81,P=0.043).In summary,the DWI ADC values for the renal cortex and medulla in the CKD group and renal cortex in the moderate sub-group were significantly lower than the healthy control subjects,WMD were-2.56(95%CI-3.73--1.41,P<0.01),-3.41(95%CI-5.52--1.31,P<0.01),and-3.86(95%CI-6.13--1.58,P<0.01),respectively.The ADC value for the renal cortex in the moderate sub-group was significantly lower than the mild sub-group(WMD=-0.84,95%CI-1.37--0.31,P=0.002).The ADC value for renal cortex in the severe sub-group was lower than the moderate sub-group(WMD=-1.28,95%CI-1.78--0.78,P=0.04).The DTI results showed that the FA value for the renal cortex in the CKD group was significantly lower than the healthy control subjects(WMD=-2.22,95%CI-3.94--0.46,P=0.013).The FA value for the renal cortex in the mild sub-group was significantly higher than the mod-erate sub-group(WMD=0.99,95%CI 0.26-1.72,P=0.008).Conclusions This meta-analysis provided evidence for BOLD,DWI,and DTI imaging as a non-invasive,safe,contrast-free method for evaluating renal function and structural changes in patients with CKD.
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