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Kidney Week

Abstract: TH-PO0348

Kidney Hemodynamic Function in Historic vs. Contemporary Patients with Type 1 Diabetes

Session Information

Category: Diabetic Kidney Disease

  • 702 Diabetic Kidney Disease: Clinical

Authors

  • Kendrick, Jessica B., University of Colorado Anschutz Medical Campus School of Medicine, Aurora, Colorado, United States
  • Furgeson, Seth B., University of Colorado Anschutz Medical Campus School of Medicine, Aurora, Colorado, United States
  • Dixon, Angelina Magreni, University of Colorado Anschutz Medical Campus School of Medicine, Aurora, Colorado, United States
  • You, Zhiying, University of Colorado Anschutz Medical Campus School of Medicine, Aurora, Colorado, United States
  • Cherney, David, Toronto General Hospital, Toronto, Ontario, Canada
  • Perkins, Bruce A., University of Toronto, Toronto, Ontario, Canada
  • Bjornstad, Petter, University of Washington School of Medicine, Seattle, Washington, United States
Background

Advances in insulin technology have led to better glycemic control in patients with type 1 diabetes (T1D), but whether renal hemodynamic function has changed over time with advances in insulin technology in T1D is unknown.

Methods

We measured renal hemodynamic function in 23 patients with long-standing T1D from an ongoing clinical trial and compared findings to those from older adults with T1D from the Canadian Study of Longevity in Type 1 Diabetes (Lytvyn et al. AJKD 2019). Glomerular filtration rate (GFR) was measured using iohexol clearance, effective renal plasma flow (RPF) measured using para-aminohippurate clearance, while intraglomerular pressure (PGLO), renal vascular resistance (RVR), efferent arteriole resistance (RE), and afferent arteriolar resistance (RA) estimated using the Gomez equations.

Results

Participants from the contemporary cohort were slightly younger and more likely to be male than the historic cohort (Table). HbA1c trended towards being lower in the contemporary cohort but it did not reach statistical significance. GFR, RPF, RBF, and PGLO were significantly greater in the contemporary vs. historic cohort. In contrast, FF, RVR, RE, and RA were significantly lower in the contemporary cohort. There were no differences in systolic blood pressure or mean arterial pressure between the groups.

Conclusion

T1D patients from the contemporary cohort had significantly less renal vasoconstriction and intraglomerular pressure than patients from the historic cohort.

ParameterContemporary Cohort (N=23)Historic Cohort (N=66)P-value
Demographic and Clinical Characteristics   
Age, years60 ± 1566 ± 80.01
Male, N (%)17 (73.9)30 (45)<0.0001
BMI, kg/m228.1 ± 6.326.6 ± 3.90.29
HbA1C, %7.0 ± 0.87.4 ± 0.80.07
Renal Hemodynamic Function   
RPF (ml/min)586 ± 112447 ± 101<0.0001
GFR (ml/min)107 ± 17103 ± 17<0.0001
Filtration Fraction0.19 ± 0.030.24 ± 0.04<0.0001
RBF (L/min)1025 ± 251689 ± 166<0.0001
RVR (mm Hg/L/min)0.09 ± 0.020.14 ± 0.04<0.0001
Intraglomerular Hemodynamic Parameters   
PGLO, mm Hg54.3 ± 4.251.4 ± 4.30.006
R E, dyne-s-cm-52,954 ± 8784,546 ± 1714<0.0001
RE, dyne-s-cm-51,586 ± 3112,403 ± 544<0.0001

Mean (SD) unless otherwise specified

Funding

  • Private Foundation Support

Digital Object Identifier (DOI)