Kidney parenchyma fat content similar between healthy controls and diabetes patients regardless of CKD status: Study

The results revealed that kidney parenchyma fat content was similar between individuals with T2D and healthy controls, regardless of CKD status. However, kidney sinus fat volume was notably higher in individuals with T2D and even higher still in those with T2D and CKD. The study suggests that while overall kidney parenchyma fat content does not significantly differ between individuals with T2D and healthy individuals, fat accumulation in the kidney sinus is more pronounced in those with diabetes, and even more so in those with concurrent CKD.

The researchers note that kidneys may be particularly vulnerable to ectopic fat and its lipotoxic effects, which could predispose them to chronic kidney disease in individuals with type 2 diabetes. To explore this further, Niels Sondergaard Heinrich, Steno Diabetes Center Copenhagen, Herlev, Denmark, and colleagues investigated whether kidney parenchyma fat content and kidney sinus fat volume are elevated in persons with T2D and CKD.

For this purpose, the researchers conducted a cross-sectional study involving 29 controls, 27 individuals with type 2 diabetes (T2D) but no chronic kidney disease, and 48 individuals with T2D and early CKD (defined by a urine albumin-creatinine ratio (UACR) ≥ 30 mg/g). Kidney parenchyma fat content was measured using magnetic resonance spectroscopy, while kidney sinus fat volume was assessed using Dixon scans.

The investigation uncovered the following findings:

• In the control, T2D without CKD, and T2D with CKD groups, median UACR values were 5, 6, and 95 mg/g, respectively.
• The mean estimated glomerular filtration rate (eGFR) was 89 ± 11, 94 ± 11, and 77 ± 22 ml/min/1.73m² in the control, T2D without CKD, and T2D with CKD groups, respectively.
• Kidney parenchyma fat content was 1.0, 0.7, and 1.0 % in the control, T2D without CKD, and T2D with CKD groups, respectively.
• Kidney sinus fat volume was 2.8, 8.0, and 10.3 ml in the control, T2D without CKD, and T2D with CKD groups, respectively.
• Approximately 90% of T2D participants were prescribed a sodium-glucose cotransporter-2 inhibitor or a glucagon-like peptide-1 receptor agonist.

In the context of modern, multifactorial management of type 2 diabetes, the study found that kidney parenchyma fat content, measured using magnetic resonance spectroscopy, was comparable between healthy controls and individuals with T2D, regardless of chronic kidney disease status. However, kidney sinus fat volume was significantly higher in individuals with T2D, and even more pronounced in those with concurrent CKD.

Reference:

Heinrich, N. S., Pedersen, R. P., Vestergaard, M. B., Lindberg, U., Andersen, U. B., Haddock, B., Fornoni, A., Larsson, H. B. W., Rossing, P., & Hansen, T. W. (2025). Kidney fat by magnetic resonance spectroscopy in type 2 diabetes with chronic kidney disease. Journal of Diabetes and its Complications, 39(2), 108923. https://doi.org/10.1016/j.jdiacomp.2024.108923