Canagliflozin could improve the levels of renal oxygenation in newly diagnosed type 2 diabetes patients with normal renal function

Objective: To evaluate the effects of canagliflozin on the renal oxygen level and blood perfusion in newly diagnosed type 2 diabetes mellitus (T2DM) patients with normal renal function. Methods: We conducted a prospective, randomised, and drug-controlled trial to determine the reno-protective effect exerted by canagliflozin in newly diagnosed T2DM patients with normal renal function using blood oxygen level-dependent magnetic resonance imaging (BOLD-MRI) and arterial spin labelling MRI (ASL-MRI). This provides an experimental basis for a first-line of defence for the prevention of diabetic nephropathy. Results: Canagliflozin induced a significant decrease in body weight and diastolic blood pressure compared with glimepiride (all p < 0.05). The high baseline mean estimated glomerular filtration rate (eGFR) in both groups was indicative of a GFR level at a relatively high status that was significantly alleviated after 24 weeks of canagliflozin treatment (change from baseline, p = 0.04, and change versus glimepiride control, p = 0.048). However, neither drug regimen significantly affected renal blood perfusion. The R2* values were inversely proportional to the tissue oxygen content. Compared to the baseline, 24 weeks of canagliflozin treatment decreased the R2* values of the renal cortex and medulla by 22.3% (p = 0.005) and 29.2% (p = 0.0002) respectively, and these decreases were significantly greater than in the glimepiride control group (p = 0.0004 and p = 0.02). Conclusions: Canagliflozin improved the levels of renal oxygenation in newly diagnosed T2DM patients with normal renal function independent of changes in renal blood perfusion. Published by Elsevier Masson SAS.

Automated summary

The study showed that canagliflozin improved renal oxygenation in newly diagnosed type 2 diabetes mellitus patients with normal renal function, independently of changes in renal blood perfusion.