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RO2 was estimated by blood oxygen level\u2013dependent MRI; fat mass was estimated by DXA; GFR and RPF were estimated by iohexol and p-aminohippurate clearance; albuminuria was estimated by urine albumin-to-creatinine ratio (UACR); and M\/I was estimated from steady-state glucose infusion rate\/insulin (mg\/kg\/min) by hyperglycemic clamp in 50 adolescents with T1D (age 16.1 \u00b1 3.0 years, HbA1c 8.6 \u00b1 1.2%) and 20 control patients of similar BMI (age 16.1 \u00b1 2.9 years, HbA1c 5.2 \u00b1 0.2%). The RO2:GFR (ms\/mL\/min) was calculated as RO2 (T2*, ms) divided by GFR (mL\/min). Whole-kidney RO2:GFR was 25% lower in adolescents with T1D versus control patients (P &amp;lt; 0.0001). In adolescents with T1D, lower whole-kidney RO2:GFR was associated with higher UACR (r = \u22120.31, P = 0.03), RPF (r = \u22120.52, P = 0.0009), and fat mass (r = \u22120.33, P = 0.02). Lower medullary RO2:GFR was associated with lower M\/I (r = 0.31, P = 0.03). In conclusion, adolescents with T1D exhibited relative renal hypoxia that was associated with albuminuria and with increased RPF, fat mass, and insulin resistance. These data suggest a potential role of renal hypoxia in the development of diabetic kidney disease.<\/jats:p>","DOI":"10.2337\/db20-0457","type":"journal-article","created":{"date-parts":[[2020,7,31]],"date-time":"2020-07-31T22:03:00Z","timestamp":1596232980000},"page":"2700-2708","update-policy":"https:\/\/doi.org\/10.2337\/ada-journal-policies","source":"Crossref","is-referenced-by-count":44,"title":["Relative Hypoxia and Early Diabetic Kidney Disease in Type 1 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