Abstract: SA-PO310
Renal Blood Flow during Adenosine-Stress by Magnetic Resonance Imaging in a Large Cohort of Patients with Type 2 Diabetes
Session Information
- Diabetic Kidney Disease: Clinical Pathology, Diagnostic and Treatment Advances
October 26, 2024 | Location: Exhibit Hall, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Diabetic Kidney Disease
- 702 Diabetic Kidney Disease: Clinical
Authors
- Sunde, Niclas, Kobenhavns Universitet, Kobenhavn, Region Hovedstaden, Denmark
- Gaede, Peter, Syddansk Universitet Det Sundhedsvidenskabelige Fakultet, Odense, Syddanmark, Denmark
Background
Type 2 diabetes (T2D) affects most organs, and clinical evaluation is a task for most specialties in internal medicine, including not only endocrinology, but notably also cardiology and nephrology. Thus, premature morbidity and mortality in T2D is largely related to cardiovascular disease and to increased risk of renal failure. Diabetic nephropathy is a microvascular complication of T2D and a leading cause of end-stage renal disease.
Methods
297 patients from Næstved/Slagelse/Ringsted Hospitals participated in the largest global study of its kind, with magnetic resonance imaging of the heart. Since T2D not only affects the heart and circulation but also the kidneys, these studies will not only focus on the heart but will utilize scans to determine, using a new technique, whether patients have normal or reduced kidney blood flow
Results
We found that perfusion of the renal cortex and medulla is lower in patients with T2D than in an age-matched control both during rest and adenosine-stress. During rest, blood perfusion of the renal cortex and medulla were 19% and 15% lower in patients with T2D than in normal age-matched control subjects (P=0.06 by unpaired t-test for renal cortex). The cortical/medulla-perfusion ratio was also lower in patients with T2D than in normal subjects. During adenosine-stress, renal cortical perfusion was 20% lower in patients with T2D than in normal subjects (P<0.001 by unpaired t-test). Renal medullary perfusion decreased to 103±46 SI units in normal subjects vs. 98±31 SI units in patients with T2D. Based on our findings, patients with T2D have comparable renal perfusion responses to adenosine but have lowered rest and stress renal cortical as well as medullary perfusions as compared to normal subjects. Further, patients with T2D during adenosine stress have comparably lower cortex/medulla-perfusion ratios than normal subjects, and hence do not seem to exhibit the same intra-renal redistribution of blood flow from the medulla to the cortex as noted in normal subjects.
Conclusion
We found a reduction in renal blood flow during rest and stress, within a cohort of patients with T2D and a board range of kidney function (uAER, eGFR) and diabetes medication compared to an age matched control group.