Phenotypic characteristics of diabetic kidney involvement Roland C. Blantz  Kidney International  Volume 86, Issue 1, Pages 7-9 (July 2014) DOI: 10.1038/ki.2013.552 Copyright © 2014 International Society of Nephrology Terms and Conditions

Figure 1 Control and diabetic kidneys during 20% (normal) and 10% inspired oxygen. Kidney oxygen consumption (QO2) is elevated in the diabetic kidneys with normal 20% inspired oxygen, contributing to a reduced tissue pO2 in the cortex of the kidney (45mmHg in control cortex and 35mmHg in diabetic cortex). Lactate and pyruvate content and generation are normal, as is the redox potential, in both control and diabetic kidneys. When inspired oxygen is reduced to 10%, control kidneys maintain normal oxidative metabolism and lactate and pyruvate levels remain constant, as does the redox potential, while cortical pO2 falls further to 35mmHg. However, in diabetic kidney tissue, QO2 is maintained at the same levels while pO2 falls further to 25mmHg, but lactate increases and pyruvate levels decrease in parallel with a marked reduction in the NAD+/NADH ratio, a shift to Warburg metabolism. Why lower inspired pO2 induces these changes is unknown, but pO2 levels should be decreased to levels comparable to those in diabetic kidneys to determine the effects on lactate and pyruvate generation. Kidney International 2014 86, 7-9DOI: (10.1038/ki.2013.552) Copyright © 2014 International Society of Nephrology Terms and Conditions