title: Arterial spin labeling MRI is able to detect early hemodynamic changes in diabetic nephropathy.
abstract: To investigate whether arterial spin labeling (ASL) MRI could detect renal hemodynamic impairment in diabetes mellitus (DM) along different stages of chronic kidney disease (CKD).
  
  
  
  Three Tesla (3T) ASL-MRI was performed to evaluate renal blood flow (RBF) in 91 subjects (46 healthy volunteers and 45 type 2 diabetic patients). Patients were classified according to their estimated glomerular filtration rate (eGFR) as group I (eGFR > 60 mL/min/1.73 m2), group II (60 ≥ eGFR>30 mL/min/1.73 m2), or group III (eGFR ≤ 30 mL/min/1.73 m2), to determine differences depending on renal function. Studies were performed at 3T using a 12-channel flexible body array combined with the spine array coil as receiver.
  
  
  
  A 28% reduction in cortical RBF was seen in diabetics in comparison with healthy controls (185.79 [54.60] versus 258.83 [37.96] mL/min/100 g, P < 3 × 10-6). Differences were also seen between controls and diabetic patients despite normal eGFR and absence of overt albuminuria (RBF [mL/min/100 g]: controls=258.83 [37.96], group I=208.89 [58.83], P = 0.0018; eGFR [mL/min/1.73 m2]: controls = 95.50 [12.60], group I = 82.00 [20.76], P > 0.05; albumin-creatinine ratio [mg/g]: controls = 3.50 [4.45], group I = 17.50 [21.20], P > 0.05). A marked decrease in RBF was noted a long with progression of diabetic nephropathy (DN) through the five stages of CKD (χ2= 43.58; P = 1.85 × 10-9). Strong correlation (r = 0.62; P = 4 × 10-10) was obtained between RBF and GFR estimated by cystatin C.
  
  
  
  ASL-MRI is able to quantify early renal perfusion impairment in DM, as well as changes according to different CKD stages of DN. In addition, we demonstrated a correlation of RBF quantified by ASL and GFR estimated by cystatin C.
  
  
  
  3 Technical Efficacy: Stage 2 J. Magn. Reson. Imaging 2017;46:1810-1817.
authors.affiliation: Nephrology, Clínica Universidad de Navarra, Pamplona, Spain.
authors.forename: José María
authors.initials: JM
authors.lastname: Mora-Gutiérrez
authors.affiliation: Nephrology, Clínica Universidad de Navarra, Pamplona, Spain.
authors.forename: Nuria
authors.initials: N
authors.lastname: Garcia-Fernandez
authors.affiliation: Nephrology, Navarra Hospital, Pamplona, Spain.
authors.forename: M Fernanda
authors.initials: MF
authors.lastname: Slon Roblero
authors.affiliation: Atherosclerosis Research Laboratory, CIMA, University of Navarra, Pamplona, Spain.
authors.forename: Jose A
authors.initials: JA
authors.lastname: Páramo
authors.affiliation: Endocrinology, Clínica Universidad de Navarra, Pamplona, Spain.
authors.forename: F Javier
authors.initials: FJ
authors.lastname: Escalada
authors.affiliation: Laboratory of Functional MRI Technology (LOFT) Stevens Neuroimaging and Informatics Institute University of Southern California, Los Angeles, California, USA.
authors.forename: Danny Jj
authors.initials: DJ
authors.lastname: Wang
authors.affiliation: Radiology, Clínica Universidad de Navarra, Spain.
authors.forename: Alberto
authors.initials: A
authors.lastname: Benito
authors.affiliation: Radiology, Clínica Universidad de Navarra, Spain.|Adjunct Associate Professor of Radiology, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
authors.forename: María A
authors.initials: MA
authors.lastname: Fernández-Seara
mesh_terms: D000328:Adult; D000368:Aged; D001783:Blood Flow Velocity / Q000502:physiology; D003928:Diabetic Nephropathies / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D005260:Female; D005919:Glomerular Filtration Rate / Q000502:physiology; D006439:Hemodynamics / Q000502:physiology*; D006801:Humans; D007668:Kidney / Q000000981:diagnostic imaging / Q000503:physiopathology; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D012079:Renal Circulation / Q000502:physiology; D015203:Reproducibility of Results; D013113:Spin Labels
chemical_list: D013113:Spin Labels
keywords: MRI; arterial spin labeling; diabetes mellitus; diabetic nephropathy; hemodynamic changes; renal perfusion