Effect of Acute Hypoxia on Renal Hemodynamic in Healthy Volunteers, Patients With Diabetes and Patients With Diabetes and Kidney Disease

Inclusion criteria

For all participant :

• No history of respiratory diseases
• Affiliated person or beneficiary of the French social security scheme.
• signed informed consent

Group 1 ( For healthy volunteers):

• [18; 40] years old
• No history of diabetes
• No acute/long term > 3 months drug use except contraception
• BMI: [18,5 - 29,9]kg/m2
• eGFR > 60ml/min/1.73m2
• Normal to midly increased albuminuria: defined as ACR < 3 mg/mmol

For all the patients with T2D (group 2 and 3):

• Diagnosed T2D according to ADA criteria
• [35; 75] years old
• Stable treatment of diabetes and/or antihypertension for at least 2 months prior to inclusion
• No proliferative diabetic retinopathy

Group 2 - For patients with T2D and no DKD:

• eGFR > 60ml/min/1.73m2 and
• Normal to midly increased albuminuria: defined as ACR < 3 mg/mmol

Group 3 - For patients with DKD:

• eGFR [45-60 ml/min/1.73m2] and/or
• Moderately to severely increased ACR ≥ 3 mg/mmol

Exclusion criteria

For all participants:

• Active smoking
• Contraindication to any of the agent (PAH, or iohexol or gadolinium) used in the study.
• Contraindication to cardiac MRI, renal MRI, respiratory tests,
• History acute coronary syndrome or coronary revascularization
• Recent (<6 months) history of: Heart failure requiring hospitalisation or Stroke or transient ischemic neurologic disorder
• Severe unstable hypertension (≥180 mmHg systolic or ≥110 mmHg diastolic blood pressure)
• Resting oxygen saturation <95% at baseline
• Any concomitant disease or condition that may interfere with the safety or the possibility for the patient to comply with or complete the study protocol.
• History of severe mountain sickness (dizziness, headache, nausea/vomiting and incapaciting fatigue)
• Consumption of SGLT2 inhibitors
• Concurrent participation in another clinical research study
• Pregnant or breastfeeding women, women of childbearing age who do not have effective contraception
• Persons benefiting from enhanced protection under french national law
• Persons under psychiatric care who are unable to give their consent