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Abstract: PO0764

Renal Oxygenation, Perfusion, and Blood Flow in Type 1 Diabetes with Albuminuria Compared with Healthy Controls

Session Information

Category: Diabetic Kidney Disease

  • 602 Diabetic Kidney Disease: Clinical

Authors

  • Laursen, Jens christian, Steno Diabetes Center Copenhagen, Gentofte, Denmark
  • Rasmussen, Ida, Steno Diabetes Center Copenhagen, Gentofte, Denmark
  • Melo, Joana, Steno Diabetes Center Copenhagen, Gentofte, Denmark
  • Haddock, Bryan, Rigshospitalet, Kobenhavn, Denmark
  • Safavimanesh, Farzaneh, Steno Diabetes Center Copenhagen, Gentofte, Denmark
  • Størling, Joachim, Steno Diabetes Center Copenhagen, Gentofte, Denmark
  • Hansen, Christian Stevns, Steno Diabetes Center Copenhagen, Gentofte, Denmark
  • Larsson, Henrik Bo Wiberg, Rigshospitalet, Kobenhavn, Denmark
  • Groop, Per-Henrik, Folkhalsanin tutkimuskeskus, Helsinki, Uusimaa, Finland
  • Frimodt-Moller, Marie, Steno Diabetes Center Copenhagen, Gentofte, Denmark
  • Andersen, Ulrik B., Rigshospitalet, Kobenhavn, Denmark
  • Rossing, Peter, Steno Diabetes Center Copenhagen, Gentofte, Denmark

Group or Team Name

  • Complications Research
Background

The mechanisms behind the progression of diabetic kidney disease in type 1 diabetes (T1D) are poorly understood. We aimed to evaluate the renal oxygenation, perfusion and blood flow using magnetic resonance imaging (MRI) in persons with T1D and albuminuria and in healthy controls (CONs).

Methods

Cross-sectional study in 15 persons with T1D and albuminuria compared with 15 CONs. MRI (3 Tesla Philips Scanner) was used to assess renal R2* (a low value corresponds to a high tissue oxygenation), renal perfusion (arterial spin labelling) and renal artery flow (phase contrast imaging). Differences in outcomes between groups and associations were adjusted for age and sex.

Results

There was no difference between groups in the mean (SD) age (T1D: 58 (14) years ; CONs: 56 (15) years; p=0.82) or in the gender distribution (33% female in both groups, p=1). Participants with T1D had a mean duration of diabetes of 38 (18) years, a higher median urine albumin creatinine ratio (UACR) (T1D: 46 (IQR 21-58) mg/g; CONs: 4 (3-6) mg/g; p<0.0001) and a lower mean estimated glomerular filtration rate (eGFR) (T1D: 73 (32) ml/min/1.73m2; CONs: 88 (15) ml/min/1.73m2; p=0.12), although not significantly for the latter. There were no significant differences between groups in renal cortical R2* (T1D: 22.2 (5.0) s-1; CONs: 22.1 (2.6); p=0.92) or medullary R2* (T1D: 33.9 (6.1) s-1; CONs: 37.7 (4.6); p=0.14). Renal cortical perfusion was lower in T1D than in CONs (T1D: 163 (40) ml/100g/min; CONs: 224 (49) ml/100g/min; <0.01), but there was no difference in the medullary perfusion (T1D: 43 (11) ml/100g/min; CONs: 44 (15) ml/100g/min; p=0.92). Renal artery blood flow was lower in T1D than in CONs (T1D: 360 (130) ml/min; CONs: 430 (113) ml/min; p=0.01). A lower renal cortical perfusion was associated with a higher UACR (p<0.01) but not with eGFR (p=0.25). A lower renal artery blood flow was associated with a higher UACR (p<0.01) and with a lower eGFR (p=0.01).

Conclusion

Renal cortical perfusion and artery blood flow were lower in persons with T1D and albuminuria than in healthy controls, confirming findings from previous studies. Impaired renal cortical perfusion and blood flow were associated with impaired renal function.

Funding

  • Private Foundation Support