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Abstract: TH-PO230

Trajectory of Kidney Function Correlates With Renal Blood Flow Evaluated by Magnetic Resonance Imaging in Diabetic Kidney Disease

Session Information

Category: Diabetic Kidney Disease

  • 602 Diabetic Kidney Disease: Clinical

Authors

  • Hockings, Paul, Antaros Medical, Molndal, Sweden
  • Makvandi, Kianoush, Sahlgrenska universitetssjukhuset, Goteborg, Sweden
  • Jensen, Gert, Sahlgrenska universitetssjukhuset, Goteborg, Sweden
  • Unnerstall, Tim, Sahlgrenska universitetssjukhuset, Goteborg, Sweden
  • Leonhardt, Henrik, Sahlgrenska universitetssjukhuset, Goteborg, Sweden
  • Haraldsson, Henrik, Antaros Medical, Molndal, Sweden
  • Hulthe, Johannes, Antaros Medical, Molndal, Sweden
  • Baid-Agrawal, Seema, Sahlgrenska universitetssjukhuset, Goteborg, Sweden
Background

New non-invasive markers are needed to increase understanding of the pathogenesis of diabetic kidney disease (DKD). We recently showed that mean arterial flow (MAF) in renal arteries determined by magnetic resonance imaging (MRI) is tightly correlated with mGFR. Here we determine whether MAF tracks mGFR over two years in individual subjects.

Methods

In this prospective study, 38 subjects with DKD and 20 age- and gender-matched healthy volunteers (HV) were included at baseline (Visit 1). 31 DKD and 17 HV subjects were re-examined at 2 years (Visit 3) and included in the study. Measured glomerular filtration rate (mGFR) using iohexol clearance, urine albumin:creatinine ratio (UACR) and a variety of MRI techniques, including phase contrast MRI for MAF, were assessed at both visits.

Results

Mean and standard deviations (SD) for MAF, mGFR, and UACR for DKD and HV at both visits are shown in Table 1. Spearman rank correlation for mGFR vs MAF was 0.90 at Visit 1 and 0.89 at Visit 3. Figure 1 shows the trajectories of individual subjects over the 2-year period.

Conclusion

HV and DKD subjects showed similar mean changes in mGFR and MAF over 2 years, but much greater individual variability in HVs as shown by the increased SD of the delta values. In general, DKD subjects (mGFR <60 at baseline) follow the trend line with reduced MAF and mGFR at Visit 3. Changes in mGFR and MAF of HV may potentially be affected by hyperfiltration in some individuals whereas others may already have utilized their renal reserve. Changes may also be due to changes in medications.

 DKD SubjectsHV Subjects
 MAF (ml/min)mGFR (ml/min/
1.73m2)
UACR (mg/g)MAF (ml/min)mGFR (ml/min/
1.73m2)
UACR (mg/g)
Visit 1631±19632±1350±641114±22682±91±0
Visit 3521±18829±14119±2191030±27580±101±1
Delta-110±105-3±569±168-111±206-2±110±1

MAF in the renal artery vs mGFR at Visit 1 (red) and Visit 3 (blue). The size of the marker shows the UACR. Individual trajectories are connected by arrows.

Funding

  • Commercial Support