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. 2025 Feb;39(2):108923.
doi: 10.1016/j.jdiacomp.2024.108923. Epub 2024 Dec 3.

Kidney fat by magnetic resonance spectroscopy in type 2 diabetes with chronic kidney disease

Niels Sondergaard Heinrich  1 , Rune Ploegstra Pedersen  2 , Mark Bitsch Vestergaard  2 , Ulrich Lindberg  2 , Ulrik Bjørn Andersen  2 , Bryan Haddock  2 , Alessia Fornoni  3 , Henrik Bo Wiberg Larsson  4 , Peter Rossing  5 , Tine Willum Hansen  6
Affiliations

Kidney fat by magnetic resonance spectroscopy in type 2 diabetes with chronic kidney disease

Niels Sondergaard Heinrich et al. J Diabetes Complications. 2025 Feb.

Abstract

Background and hypothesis: The kidneys may be susceptible to ectopic fat and its lipotoxic effects, disposing them to chronic kidney disease (CKD) in type 2 diabetes (T2D). We investigated whether the kidney parenchyma fat content and kidney sinus fat volume would be higher in persons with T2D and CKD.

Methods: Cross-sectional study including 29 controls, 27 persons with T2D and no CKD, and 48 persons with T2D and early CKD (urine albumin creatinine ratio (UACR) ≥ 30 mg/g). Kidney parenchyma fat content and kidney sinus fat volume were assessed using magnetic resonance spectroscopy and Dixon scans respectively.

Results: In the control, T2D without CKD and T2D with CKD groups, respectively, median [1st - 3rd quartile] UACR was 5 [4 - 6], 6 [5 - 10] and 95 [43 - 278] mg/g. and mean ± standard deviation estimated glomerular filtration rate was 89 ± 11, 94 ± 11 and 77 ± 22 ml/min/1.73m2. Kidney parenchyma fat content was, respectively, 1.0 [0.5-2.4], 0.7 [0.2-1.2], 1.0 [0.3-2.0] % (p = 0.26). Kidney sinus fat volume was 2.8 [1.6-7.6], 8.0 [4.7-11.3], 10.3 [5.7-14.0] ml (p < 0.01). Around 90 % of T2D participants received a sodium-glucose cotransporter-2 inhibitor or glucagon-like peptide-1 receptor agonist.

Conclusions: In a setting of modern, multifactorial T2D management, kidney parenchyma fat content, evaluated with magnetic resonance spectroscopy, was similar among healthy controls and persons with T2D irrespective of CKD status. Still, kidney sinus fat volume was higher in the presence of T2D and higher still with CKD.

Keywords: Chronic kidney disease; Ectopic kidney fat; Magnetic resonance imaging; Type 2 diabetes.

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Conflict of interest statement

Declaration of competing interest NSH assumed a full-time position at Novo Nordisk A/S 1st March 2023 and owns stocks in Novo Nordisk A/S. TWH owns stocks in Novo Nordisk A/S. AF is an inventor on pending (PCT/US2019/032215; US 17/057,247; PCT/US2019/041730; PCT/US2013/036484; US 17/259,883; US17/259,883; JP501309/2021, EU19834217.2; CN-201980060078.3; CA2,930,119; CA3,012,773,CA2,852,904) or issued patents (US10,183,038 and US10,052,345) aimed at preventing and treating renal disease. She stands to gain royalties from their future commercialization. AF is Vice-President of L&F Health LLC and is a consultant for ZyVersa Therapeutics, Inc. ZyVersa Therapeutics, Inc has licensed worldwide rights to develop and commercialize hydroxypropyl-beta-cyclodextrin for the treatment of kidney disease. AF also holds equities in Renal 3 River Corporation. PR has received fees (to his institution) for consultancy and/or speaking from Astellas, AstraZeneca, Bayer, Boehringer Ingelheim, Gilead, Eli Lilly, MSD, Mundipharma, Novo Nordisk and Sanofi Aventis, and research grants from AstraZeneca and Novo Nordisk. The other authors report no potential conflicts of interest.

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