Frontiers in Endocrinology (Aug 2024)

Effects of canagliflozin on kidney oxygenation evaluated using blood oxygenation level-dependent MRI in patients with type 2 diabetes

  • Katsuhito Mori,
  • Tsutomu Inoue,
  • Yuri Machiba,
  • Hideki Uedono,
  • Shinya Nakatani,
  • Masahiro Ishikawa,
  • Masahiro Ishikawa,
  • Satsuki Taniuchi,
  • Yutaka Katayama,
  • Akira Yamamoto,
  • Naoki Kobayashi,
  • Eito Kozawa,
  • Taro Shimono,
  • Yukio Miki,
  • Hirokazu Okada,
  • Masanori Emoto,
  • Masanori Emoto

DOI
https://doi.org/10.3389/fendo.2024.1451671
Journal volume & issue
Vol. 15

Abstract

Read online

BackgroundRecent clinical studies suggest protective effects of SGLT2 inhibitors on kidney disease outcome. Chronic hypoxia has a critical role in kidney disease development, thus we speculated that canagliflozin, an SGLT2 inhibitor, can improve kidney oxygenation.MethodsA single-arm study was conducted to investigate the effects of canagliflozin on T2* value, which reflects oxygenation level, in patients with type 2 diabetes (T2D) using repeated blood oxygenation level-dependent MRI (BOLD MRI) examinations. Changes in cortical T2* from before (Day 0) to after single-dose treatment (Day 1) and after five consecutive treatments (Day 5) were evaluated using 12-layer concentric objects (TLCO) and region of interest (ROI) methods.ResultsIn the full analysis set (n=14 patients), the TLCO method showed no change of T2* with canagliflozin treatment, whereas the ROI method found that cortical T2* was significantly increased on Day 1 but not on Day 5. Sensitivity analysis using TLCO in 13 well-measured patients showed that canagliflozin significantly increased T2* on Day 1 with no change on Day 5, whereas a significant improvement in cortical T2* following canagliflozin treatment was found on both Day 1 and 5 using ROI.ConclusionsShort-term canagliflozin treatment may improve cortical oxygenation and lead to better kidney outcomes in patients with T2D.

Keywords