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High altitude may alter oxygen availability and renal metabolism in diabetics as measured by hyperpolarized [1-C-13]pyruvate magnetic resonance imaging
Aarhus University, Denmark; Copenhagen University Hospital Hvidovre, Denmark .
Uppsala University, Sweden .
Linköping University, Department of Medical and Health Sciences, Division of Drug Research. Linköping University, Faculty of Health Sciences. Linköping University, Center for Medical Image Science and Visualization (CMIV). Uppsala University, Sweden .
Aarhus University Hospital, Denmark; Aarhus University, Denmark.
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2014 (English)In: Kidney International, ISSN 0085-2538, E-ISSN 1523-1755, Vol. 86, no 1, 67-74 p.Article in journal (Refereed) Published
Abstract [en]

The kidneys account for about 10% of the whole body oxygen consumption, whereas only 0.5% of the total body mass. It is known that intrarenal hypoxia is present in several diseases associated with development of kidney disease, including diabetes, and when renal blood flow is unaffected. The importance of deranged oxygen metabolism is further supported by deterioration of kidney function in patients with diabetes living at high altitude. Thus, we argue that reduced oxygen availability alters renal energy metabolism. Here, we introduce a novel magnetic resonance imaging (MRI) approach to monitor metabolic changes associated with diabetes and oxygen availability. Streptozotocin diabetic and control rats were given reduced, normal, or increased inspired oxygen in order to alter tissue oxygenation. The effects on kidney oxygen metabolism were studied using hyperpolarized [1-C-13]pyruvate MRI. Reduced inspired oxygen did not alter renal metabolism in the control group. Reduced oxygen availability in the diabetic kidney altered energy metabolism by increasing lactate and alanine formation by 23% and 34%, respectively, whereas the bicarbonate flux was unchanged. Thus, the increased prevalence and severity of nephropathy in patients with diabetes at high altitudes may originate from the increased sensitivity toward inspired oxygen. This increased lactate production shifts the metabolic routs toward hypoxic pathways.

Place, publisher, year, edition, pages
Nature Publishing Group, 2014. Vol. 86, no 1, 67-74 p.
Keyword [en]
hyperpolarization; kidney; MRI; renal metabolism; type 1 diabetes
National Category
Clinical Medicine
Identifiers
URN: urn:nbn:se:liu:diva-109237DOI: 10.1038/ki.2013.504ISI: 000338601700015PubMedID: 24352155OAI: oai:DiVA.org:liu-109237DiVA: diva2:737175
Available from: 2014-08-12 Created: 2014-08-11 Last updated: 2017-12-05Bibliographically approved

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Palm, Fredrik

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