# Renal HEIR Study: Renal Hemodynamics, Energetics and Insulin Resistance in Youth Onset Type 2 Diabetes Study

> **NIH NIH K23** · UNIVERSITY OF COLORADO DENVER · 2020 · $192,240

## Abstract

Project Summary
Diabetic kidney disease (DKD) is the leading cause of renal failure in the United States. Current treatments,
such as control of hyperglycemia and hypertension, are beneficial, but only partially protective in patients with
type 2 diabetes (T2D). Clinical trials in DKD have yielded disappointing results, partly due to limited
understanding of what initiates DKD, a potentially misguided focus on albuminuria, and lack of intervention at
an early stage of disease when benefit is most likely. Therefore, identifying new therapeutic targets to impede
progression of DKD remains a public health priority. Early DKD, including hyperfiltration, is common in youth
with T2D. Renal hypoxia, stemming from a mismatch between renal oxygen utilization and consumption, is
increasingly proposed to be a unifying pathway in the development of DKD. The kidneys have a high-energy
requirement to sustain normal hemodynamic function. However, in T2D, there are emerging animal data that
the kidneys are not able to sufficiently compensate for hyperfiltration and the effects of insulin resistance (IR)
on fuel utilization. The pathophysiology underlying the relationship between IR and early DKD in youth-onset
T2D is unclear, and it remains unproven whether the relationship is attributed to changes in intrarenal
hemodynamic function and/or renal hypoxia. Dedicated translational studies are needed to unravel the
complex metabolic pathophysiology behind the development of DKD in T2D.
Dr. Bjornstad is establishing himself as a young investigator who is committed to patient-oriented research
focused on early DKD. This K23 award would provide Dr. Bjornstad with the support necessary to accomplish
the following goals: 1) to define intrarenal hemodynamic function (by iohexol and para-aminohippurate
clearance); 2) renal oxygenation and perfusion (by MRI) in T2D youth vs. obese and lean controls, and
between T2D youth with and without hyperfiltration; 3) to test the associations between insulin sensitivity (by
hyperinsulinemic-euglycemic clamp) with intrarenal hemodynamic function and renal oxygenation.
This proposal will provide dedicated time for Dr. Bjornstad to 1) perform translational research in a multi-
disciplinary setting that integrates expertise from the fields of endocrinology, nephrology, cardiology and
radiology; 2) gain hands-on experience in patient-oriented research, including primary data collection and
analysis, study design, and execution; 3) acquire expertise in advanced and unique translational research
methods; 4) set the platform for a career as an independent clinical investigator focused on interventional
studies that will test novel therapies to impede the development of early DKD. To achieve these goals, Dr.
Bjornstad has assembled a nationally-recognized mentoring team led by his primary mentors, Dr. Nadeau,
Associate Professor of Pediatric Endocrinology and Dr. Johnson, Chief of Division of Nephrology at University
of Colorado, Denver (UCD),...

## Key facts

- **NIH application ID:** 9923652
- **Project number:** 5K23DK116720-03
- **Recipient organization:** UNIVERSITY OF COLORADO DENVER
- **Principal Investigator:** Petter Bjornstad
- **Activity code:** K23 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $192,240
- **Award type:** 5
- **Project period:** 2018-07-01 → 2023-04-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9923652

## Citation

> US National Institutes of Health, RePORTER application 9923652, Renal HEIR Study: Renal Hemodynamics, Energetics and Insulin Resistance in Youth Onset Type 2 Diabetes Study (5K23DK116720-03). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/9923652. Licensed CC0.

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