Research Article Alterations of Renal Function in Patients with Diabetic Kidney Disease: A BOLD and DTI Study Xiaobao Wei , 1 Runyue Hu, 2 Xiaoli Zhou, 2 Lihua Ni, 1 Dongqing Zha, 1 Huiling Feng, 1 Haibo Xu , 2 and Xiaoyan Wu 1 1 Department of Nephrology, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, China 2 Department of Radiology, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, China Correspondence should be addressed to Haibo Xu; xuhaibo1120@hotmail.com and Xiaoyan Wu; wuxiaoyan2k6@163.com Received 20 July 2022; Revised 17 August 2022; Accepted 23 August 2022; Published 30 September 2022 Academic Editor: Amandeep Kaur Copyright © 2022 Xiaobao Wei et al. is is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Objectives. Our study aims to determine the patterns of renal oxygenation changes and microstructural changes by BOLD and DTI with deteriorating kidney function in patients with diabetic kidney disease (DKD). Methods. Seventy-two patients with type 2 diabetes mellitus (DM) and twenty healthy controls (HCs) underwent laboratory examinations, and renal BOLD and DTI images were obtained on a 3T-MRI machine. R2 * , fractional anisotropy (FA), and average diffusion coefficient (ADC) values were evaluated. DM patients were divided into three subgroups (Group-DI/DII/DIII, based on urinary albumin-creatinine ratio (UACR)) and a nondiabetic kidney disease group (Group-NDKD). D-value and MCR of R2 * and FA were proposed to evaluate the differentiation between medulla and cortex of the individual kidney among HCs and three subgroups for reducing individual differences. Comparisons were made between NDKD and kidney function-matched DKD patients. Correlations between MRI parameters and renal clinical indices were analyzed. Results. Compared with Group-HC/DI, medullary R2 * and FA values were significantly different in Group-DII/III. e D-value of R2 * and FA in Group-III were significantly smaller than that in Group-HC. However, only MCR of R2 * in Group-III was significantly smaller than that in HCs. Medullary R2 * and FA were negatively associated with serum creatinine (SCr) and cystatin C (Cys C) and positively associated with eGFR. Conclusions. With renal function declining, BOLD and DTI could capture alterations including the first rising and then falling medullary R2 * , continuously declining medullary FA, and apparent cortex-medullary differentiation in DKD patients. e MRI parameters showed renal changes accompanied by varying degrees of albuminuria, sharing common involvement in DKD and NDKD patients, but it was hard to distinguish between them. BOLD seemed more sensitive than DTI in identifying renal cortex-medullary differentiation. 1. Introduction Diabetes usually results in complications, affecting the nerves, eyes, kidneys, and cardiovascular system, which leads to decreased quality of life and a greater risk of death than similarly aged healthy people [1]. DKD has been reported to have an incidence of 20% ∼ 40% in diabetic patients in European and American countries [2, 3]. In 2011, the prevalence of DKD in hospitalized patients in China began to exceed that of glomerular nephritis-related chronic kidney disease and the gap has been increasing [4, 5]. e American Diabetes Association (ADA) and Kidney Disease: Improving Global Outcomes (KDIGO) group suggest that the detection of the urinary albumin/creatinine ratio (UACR) and eGFR should be appropriately frequent to better diagnose and treat DKD [6, 7]. e clinical symptoms of early DKD are not obvious. Patients may have dry mouth, anorexia, stomach upset, fatigue, weakness, mild eyelid edema, or even numbness, but usually do not have symp- toms such as moderate edema, nausea, and vomiting. When urinary microalbumin (uAlb) or SCr is used as a basic means to predict and screen DKD, once it is abnormal, kidney function already declines significantly [8, 9]. Biomarkers, including indicators of glomerular damage and tubular damage, inflammatory factors, proteomics, and even microRNAs, require in-depth clinical validation [10]. Hindawi Computational Intelligence and Neuroscience Volume 2022, Article ID 6844102, 11 pages https://doi.org/10.1155/2022/6844102