Kidney Week

Abstract: TH-PO724

Coronary Artery Calcification Scores and Intrarenal Hemodynamic Function in Adults with Type 1 Diabetes of ≥50 Years’ Duration: Results from Canadian Study for Longevity in Type 1 Diabetes

Session Information

• Diabetic and Obesity Induced Kidney Disease - Clinical - I
  November 02, 2017 | Location: Hall H, Morial Convention Center
  Abstract Time: 10:00 AM - 10:00 AM

Category: Diabetes

• 502 Diabetes Mellitus and Obesity: Clinical

Authors

• Lovshin, Julie A, University of Toronto, Toronto, Ontario, Canada

Julie A Lovshin,

• Bjornstad, Petter, Children's Hospital Colorado, Aurora, Colorado, United States

Petter Bjornstad,

• Lovblom, Leif Erik, Lunenfeld-Tanenbaum Research Institute, Toronto, Ontario, Canada

Leif Erik Lovblom,

• Lytvyn, Yuliya, University of Toronto, Toronto, Ontario, Canada

Yuliya Lytvyn,

• Boulet, Genevieve, Lunenfeld-Tanenbaum Research Institute, Toronto, Ontario, Canada

Genevieve Boulet,

• Farooqi, Mohammed A. Malik, Lunenfeld-Tanenbaum Research Institute, Toronto, Ontario, Canada

Mohammed A. Malik Farooqi,

• Bai, Johnny-Wei, Lunenfeld-Tanenbaum Research Institute, Toronto, Ontario, Canada

Johnny-Wei Bai,

• Lai, Vesta S, University of Toronto, Toronto, Ontario, Canada

Vesta S Lai,

• Cham, Leslie, University of Toronto, Toronto, Ontario, Canada

Leslie Cham,

• Tse, Josephine, University of Toronto, Toronto, Ontario, Canada

Josephine Tse,

• Orszag, Andrej, Lunenfeld-Tanenbaum Research Institute, Toronto, Ontario, Canada

Andrej Orszag,

• Scarr, Daniel, Lunenfeld-Tanenbaum Research Institute, Toronto, Ontario, Canada

Daniel Scarr,

• Weisman, Alanna, Lunenfeld-Tanenbaum Research Institute, Toronto, Ontario, Canada

Alanna Weisman,

• Keenan, Hillary A., Joslin Diabetes Center, Boston, Massachusetts, United States

Hillary A. Keenan,

• Brent, Michael, University of Toronto, Toronto, Ontario, Canada

Michael Brent,

• Paul, Narinder, University of Toronto, Toronto, Ontario, Canada

Narinder Paul,

• Bril, Vera, University of Toronto, Toronto, Ontario, Canada

Vera Bril,

• Perkins, Bruce A., University of Toronto, Toronto, Ontario, Canada

Bruce A. Perkins,

• Cherney, David, University of Toronto, Toronto, Ontario, Canada

David Cherney,

Background

Diabetic nephropathy (DN) carries a significant risk for premature cardiovascular (CV) mortality. It is unclear whether atherosclerosis associates with intrarenal hemodynamic dysfunction in type 1 diabetes (T1D).

Methods

T1D (n=69) and age/sex-matched controls without diabetes (n=73) underwent CAC volume scoring by electron beam CT [mean age 65±8 years, 81(57%) female]. Gold standard measures of glomerular filtration rate [GFR_INULIN] and effective renal plasma flow [ERPF_PAH] were used, and renal blood flow [RBF], renal vascular resistance [RVR], and afferent (R_A) and efferent (R_E) arteriole resistances were derived from Gomez’ equations. The cohort was dichotomized to high (≥300 AU) or low (<300 AU) CAC and stratified by T1D status. Additionally, linear regression was used to examine relationships between CAC (transformed) and intrarenal hemodynamic function, adjusting for age, sex, and HbA1c.

Results

Compared to controls, T1D subjects had higher prevalence of high CAC (68 vs. 14%, p<0.001) and median CAC volumes (1000[222,2373] AU vs. 1[0,75] AU, p<0.001). Mean baseline GFR_INULIN was 103±17 mL/min/1.73m² in T1D and 106±19 mL/min/1.73m² in controls (p=0.34). In T1D, high CAC was associated with higher HbA1c, presence of neuropathy, and a history of macrovascular disease. In T1D and in controls, no parameter of intrarenal hemodynamic function including GFR

Conclusion

Despite the strong epidemiologic relationships between DN and CV disease, the presence of atherosclerosis did not impact intrarenal hemodynamic function to RAAS activation in older adults with longstanding T1D.