# Scalable imaging approach to measure muscle bioenergetics in CKD.

> **NIH AR R21** · ALBERT EINSTEIN COLLEGE OF MEDICINE · 2026 · $556,651

## Abstract

Project Summary/Abstract
Skeletal muscle dysfunction causes frailty and disability in patients with chronic kidney disease (CKD) and
contributes to their extremely high rates of mortality. A major contributor to poor muscle function in CKD is
mitochondrial dysfunction; thus, the ability to identify affected patients is critical. Indeed, in vivo measurements
of mitochondrial or oxidative capacity can be highly informative; they correlate with muscular endurance and
may predict future loss of physical performance abilities. However, in vivo assessment of muscle oxidative
capacity is typically performed using 31P magnetic resonance spectroscopy (MRS), which cannot be performed
widely because of the need for dedicated expertise and hardware. We propose to use innovative technology to
address this gap. We have developed a novel molecular magnetic resonance imaging (MRI)-based
method that utilizes existing MRI hardware and clinical consoles in combination with innovative physics to
interrogate muscle bioenergetics in a push-button manner. Our approach uses chemical exchange saturation
transfer (CEST) MRI to simultaneously quantify both phosphocreatine (PCr) and creatine pools in skeletal
muscle. This method, as does 31P-MRS, quantifies PCr recovery after exercise, which is the classical in vivo
measure of ATP generation. Our primary objective is to quantify deficits in skeletal muscle
mitochondrial bioenergetics in patients with severe CKD using CEST MRI. This proposal leverages our
ongoing R01-funded prospective cohort study of patients with advanced CKD, which has assembled a patient
cohort with detailed clinical, functional, and biochemical phenotyping, as well as muscle biopsies and
quantitative MRI scans assessing multiple domains of skeletal muscle health. Aim 1 will determine the extent
to which skeletal muscle mitochondrial bioenergetics is impaired in patients with severe, non-dialysis
dependent CKD. Muscle bioenergetics will be tested pre- and post-plantar flexi

## Key facts

- **NIH application ID:** 11319535
- **Project number:** 1R21AR087144-01
- **Recipient organization:** ALBERT EINSTEIN COLLEGE OF MEDICINE
- **Principal Investigator:** Matthew K Abramowitz
- **Activity code:** R21 (R01, R21, SBIR, etc.)
- **Funding institute:** AR
- **Fiscal year:** 2026
- **Award amount:** $556,651
- **Award type:** 1
- **Project period:** 2026-03-04T00:00:00 → 2028-02-29T00:00:00

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/11319535

## Citation

> US National Institutes of Health, RePORTER application 11319535, Scalable imaging approach to measure muscle bioenergetics in CKD. (1R21AR087144-01). Retrieved via AI Analytics 2026-07-13 from https://api.ai-analytics.org/grant/nih/11319535. Licensed CC0.

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