Why do we care?

DKD is the leading cause of kidney failure in the U.S. and in Colorado, and the number of people affected has quadrupled over the past 30 years, leading to increases in co-morbidities and mortality. Current medical treatments are only partially protective in patients with T1D and T2D, and numbers of patients developing T2D and DKD are rising in youth due to the obesity epidemic.

What do we know?

Early in the course of kidney injury, the filtration elements of the kidneys work excessively, called hyperfiltration, which is common in youth with both T1D and T2D. Our research supports strong associations between insulin resistance, which is found in T1D and T2D, and hyperfiltration. Existing research indicates that hyperfiltration increases the kidney’s oxygen and energy needs. However, insulin resistance impairs the kidney cell’s ability to effectively use oxygen as fuel. The mismatch between fuel delivery and demand results in insufficient oxygen, inflammation, and kidney damage.

What do we hope to learn?

Our studies focus on defining the relationships between insulin resistance, renal energetics and function in early DKD by using clamps, renal physiology studies and state-of-the-art MRI and pet assessments. A better understanding of the metabolic and hemodynamic mechanisms underlying the development of DKD can help us better understand how to slow, stop or completely prevent DKD.