BOLD MRI to Evaluate the Effects of Sacubitril/Valsartan on Renal Protection in Type 2 Diabetics

Limin Zhai,1 Yue Wang,1 Li Xiang,2 Liang-ping Ni,2 Deyuan Zhang,1 Tianrong Pan1 1Department of Endocrinology, The Second Affiliated Hospital of Anhui Medical University, Hefei, People’s Republic of China; 2Department of Radiology, The Second Affiliated Hospital of Anhui Medical University, Hefei, People’s Republic of ChinaCorrespondence: Tianrong Pan, The Second Affiliated Hospital of Anhui Medical University, No. 678 Furong Road, Hefei, Anhui Province, 230601, People’s Republic of China, Email [email protected] Deyuan Zhang, The Second Affiliated Hospital of Anhui Medical University, No. 678 Furong Road, Hefei, Anhui Province, 230601, People’s Republic of China, Email [email protected]: To investigate the effects of sacubitril/valsartan on diabetic nephropathy patients by blood-oxygenation-level dependent-magnetic resonance imaging (BOLD-MRI).Methods: Forty-eight Patients with diabetic kidney disease (DKD) admitted to our hospital from April 2023 to December 2024 were selected. They were divided into two groups based on the treatment obtained. The dapagliflozin group included dapagliflozin 10 mg once daily, and the Sacubitril/valsartan group included a combination of dapagliflozin and sacubitril/valsartan for 12 weeks. The plasma and urine biochemistry parameters of all patients were compared. Meanwhile, renal was scanned by BOLD MRI before and after experiment endpoint.Results: After 12 weeks treatment, biochemical indexes from baseline were improved in both dapagliflozin group and sacubitril/valsartan group. Sacubitril/valsartan treatment significantly reduced UACR and UNAG excretion, as well as decreased the R2* values of the kidney medulla, compared to the dapagliflozin group (p < 0.05).Conclusion: Sacubitril/valsartan can provide protection in DKD by reducing UACR and UNAG excretion while improving the oxygenation of the medulla area of the kidney, beyond its hypoglycemic and antihypertensive effects.Keywords: BOLD MRI, Sacubitril/valsartan, diabetic kidney disease, natriuretic peptide