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. 2016 Mar;4(5):e12714.
doi: 10.14814/phy2.12714.

Early diabetic kidney maintains the corticomedullary urea and sodium gradient

Haiyun Qi  1 , Thomas S Nørlinger  1 , Per M Nielsen  1 , Lotte B Bertelsen  1 , Emmeli Mikkelsen  1 , Yafang Xu  1 , Hans Stødkilde Jørgensen  1 , Christoffer Laustsen  2
Affiliations

Early diabetic kidney maintains the corticomedullary urea and sodium gradient

Haiyun Qi et al. Physiol Rep. 2016 Mar.

Erratum in

  • Erratum.
    [No authors listed] [No authors listed] Physiol Rep. 2016 May;4(9):e12797. doi: 10.14814/phy2.12797. Physiol Rep. 2016. PMID: 27147498 Free PMC article. No abstract available.

Abstract

Early diabetic nephropathy is largely undetectable before substantial functional changes have occurred. In the present study, we investigated the distribution of electrolytes and urea in the early diabetic kidney in order to explore whether pathophysiological and metabolic changes appear concomitantly with a decreased sodium and urea gradient. By using hyperpolarized (13)C urea it was possible to measure the essential intrarenal electrolyte gradients and the acute changes following furosemide treatment. No differences in either intrarenal urea or sodium gradients were observed in early diabetes compared to healthy controls. These results indicate that the early metabolic and hypertrophic changes occurring in the diabetic kidney prelude the later functional alterations in diabetic kidney function, thus driving the increased metabolic demand commonly occurring in the diabetic kidney.

Keywords: Hyperpolarization; MRI; kidney; renal function; type 1 diabetes.

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Figures

Figure 1
Figure 1
mRNA expression of KIM‐1 is significantly increased in the diabetic group. mRNA expression of NGAL, IL‐1, α‐SMA, Nqo‐1, KIM‐1,TNF‐α, and collegan‐1 is similar between the control and diabetic groups (median ± min–max).
Figure 2
Figure 2
Representation of both kidneys (blue circles) in 1H MR images (left), renal distribution of sodium (23Na) (middle) and hyperpolarized 13C urea signal (16th image, 32 sec after start of injection) (right) in a diabetic and control animal. The zoomed image in the upper left corner shows the individual renal cortex, medulla, and pelvis in the right kidney (red arrow).
Figure 3
Figure 3
The renal perfusion (renal compartment/aorta signal) shows no significant alterations in the early diabetic kidney compared to control kidneys (mean ± SEM).
Figure 4
Figure 4
The intrarenal sodium and urea signals (normalized to the total renal signal) show no difference between the diabetic group and the control group, whereas a significant difference is present within each group (mean ± SEM).
Figure 5
Figure 5
Healthy rats (N = 4) examined prior to and after (20 min) a furosemide injection show a significant reduction in the medullary urea signal after 34 sec (mean ± SEM).
See this image and copyright information in PMC

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