We have also identified Ach and its regulators, including AR, STAT3 and AKT pathways, which could be used as potential targets for the treatment of HCC. The global increase in chronic kidney disease parallels the obesity epidemic. Obese subjects have a weight-dependent 2- to 7-fold increased risk in progression of CKD irrespective of the underlying cause. Surprisingly, little is known on how obesity can progress or even lead to renal disease. Obesity is associated with a secondary form of focal segmental glomerulosclerosis, coined obesity-related glomerulopathy when no other primary renal disease appears present. A recent study found a ten-fold increased incidence of ORG in native kidney biopsies between 1986�C2000, suggesting a newly emerging epidemic. Accumulating evidence from experimental and scarce limited human biopsy studies link ectopic lipid deposition in the kidney to the development of ORG. Unfortunately, clinical research on renal adiposity is hampered by the fact that it is considered unethical to biopsy human kidneys without clear evidence of renal disease. Proton magnetic resonance spectroscopy is 
a tool for metabolic imaging to non-invasively assess triglyceride content in different human tissues in vivo, including the heart, liver and skeletal muscle. Spectral quality and reproducibility of e.g. cardiac 1H-MRS are influenced by respiratory motion. Compensation for respiratory motion using navigator gating and volume tracking improves myocardial spectral quality and reproducibility. However, 1H-MRS for detection of renal TG content has never been performed to our knowledge. Furthermore, the possible effects of respiratory motion on reproducibility are unknown. The purpose of this study was to assess the feasibility of renal 1H-MRS and to compare spectral quality and reproducibility without and with respiratory motion compensation in vivo. The results show that 1H-MRS is a feasible tool to assess cortical TG content in humans in vivo and use of respiratory motion compensation with navigator echoes significantly improves spectral quality and reproducibility. In a subset of volunteers spectra with deliberate voxel misplacement with localization in the renal sinus were also measured. A point resolved spectroscopy sequence was used to acquire single voxel MR spectroscopic data. Per acquisition 1024 data points were promote academic research health care benefits gprd acquired using 1000 Hz spectral bandwidth and averaged over 64 acquisitions. A TR of 3000 ms was chosen to approach complete relaxation of the TG signals. For respiratory motion compensation a pencil beam navigator was positioned on the right hemi-diaphragm. A two-dimensional spatially selective RF pulse for pencil beam-shaped excitation was used. A pencil beam of 25 mm diameter was selected. Respiratory navigator gated spectroscopic data were accepted during in a predefined acceptance window of 5mm diaphragm displacement in end-expiration. Residual motion was compensated with motion tracking. Preparation phases, including F0 determination, gradient shimming and water suppression were performed using respiratory motion compensation. To generate an internal reference, a spectrum without water suppression with a repetition time of 10 s and 4 averages was obtained, without changing any other parameter. Total acquisition time for both a water suppressed and water unsuppressed spectrum, including positioning of the patient, shimming, and parameter adjustment for water suppression, was on average 20 min. The present study shows that metabolic imaging of the human kidney for detection of cortical TG content using 1H-MRS is feasible. Respiratory motion compensation improves spectral quality and measurement reproducibility. Intracellular lipid accumulation causing lipotoxicity in humans with the metabolic syndrome or type-2 diabetes mellitus, as assessed with 1H-MRS, has been associated with organ dysfunction.