Focused Ultrasound Therapy
Focused ultrasound is an early-stage, noninvasive, therapeutic technology with the potential to improve the quality of life and decrease the cost of care for patients with acute tubular necrosis (ATN). This novel technology focuses beams of ultrasound energy precisely and accurately on targets in the body without damaging surrounding normal tissue. Where the beams converge, the ultrasound produces treatment of the renal artery, which causes the endothelial layer to release nitric oxide, and cause a temporary vasodilation. In addition, focused ultrasound treatment of the renal artery also causes a temporary enhancement of the permeability of the downstream glomerulus. Both of these changes improve the ability of the kidney to handle the cause of the tubular necrosis. Further research is needed to determine whether these effects can be observed in kidneys affected by or at risk for ATN.
The primary options for treatment of acute tubular necrosis include medication and sometimes dialysis or invasive surgery.
For certain patients, focused ultrasound could provide a noninvasive alternative to surgery with less risk of complications and lower cost.
- Focused ultrasound is noninvasive, so it does not carry added concerns like surgical wound healing or infection.
- Focused ultrasound can reach the desired target without damaging surrounding tissue.
- It can be repeated, if necessary.
At the present time, there are no clinical trials recruiting patients for focused ultrasound treatment of acute tubular necrosis.
Regulatory Approval and Reimbursement
Focused ultrasound treatment for acute tubular necrosis is not yet approved by regulatory bodies or covered by medical insurance companies.
Yang FY, Chiu WH. Focused ultrasound-modulated glomerular ultrafiltration assessed by functional changes in renal arteries. PLoS One. 2013.
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F.-Y. Yang, W.-H. Chiu, S.-H. Liu, G.-L. Lin, and F.-M. Ho, Functional changes in arteries induced by pulsed high-intensity focused ultrasound. IEEE Trans. Ultrason. Ferroelectr. Freq. Control., vol. 56, no. 12, pp. 2643–2649, Dec. 2009.
A. Maruo, C. E. Hamner, A. J. Rodrigues, T. Higami, J. F. Greenleaf, and H. V. Schaff, Nitric oxide and prostacyclin in ultrasonic vasodilatation of the canine internal mammary artery. Ann. Thorac. Surg., vol. 77, no. 1, pp. 126–132, Jan. 2004.
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