31P-magnetic resonance spectroscopy (31P-MRS) detects early changes in kidney high-energy phosphate metabolism during a 6-month Valsartan treatment in diabetic and non-diabetic kidney-transplanted patients

P-31-magnetic resonance spectroscopy (P-31-MRS) is a non-invasive tool to study high-energy phosphate (HEP) metabolism. We evaluate whether P-31-MRS can detect early changes in kidney HEP metabolism during a 6-month trial with Valsartan. Twenty consecutive stable and normotensive kidney-transplanted patients were enrolled. Nine of them received short-term low-dose Valsartan treatment (80 mg/day) for 6 months, while 11 controls received no medication. Kidney HEP metabolism was evaluated both at baseline and after treatment by P-31-MRS with a 1.5 T system (Gyroscan Intera Master 1.5 MR System; Philips Medical Systems, Best, The Netherlands). Valsartan-treated patients (n = 9) showed a significant increase in beta-ATP/Pi ratio, a marker of kidney HEP metabolism (baseline = 1.03 +/- 0.08 vs. 6 months = 1.26 +/- 0.07, p = 0.03). In contrast, the beta-ATP/Pi ratio in the control group (n = 11) did not change (baseline = 0.85 +/- 0.10 vs. 6 months = 0.89 +/- 0.08, ns). The improvement in the beta-ATP/Pi ratio was not associated with a reduction in arterial blood pressure or in urinary albumin excretion. Kidney-localized P-31-MRS can detect early changes in kidney HEP metabolism during a short-term low-dose Valsartan treatment in stable normotensive kidney-transplanted patients.