To explore whether the pathophysiological and metabolic changes appear concomitant with decreased intrarenal sodium and urea gradient in early diabetes.Twelve ten-week female Wistar rats were randomly divided into two groups, one receiving an intravenous injection of freshly prepared streptozotocin (STZ, 55 mg/kg body weight) to induce insulinopenic diabetes, or another group serving as healthy normoglycemic controls. Rats were considered diabetic if blood glucose levels exceeded 15 mmol/L 48hours (h) after administration of STZ. Two weeks after induction of diabetes, the rats were anesthetized and a tail vein catheter was inserted for injection of hyperpolarized ¹³C urea, the ¹³C urea was polarized in a SPINLAB (GE Healthcare, Broendby, DK). Temperature, hemoglobin oxygen saturation and respiration rate were monitored throughout the experiment. Each animal received injections of 1.5 ml hyperpolarized urea over 10 seconds (s). The experiments were performed in a 9.4 T pre-clinical MR system (Agilent, UK) equipped with a dual tuned ¹³C/¹H volume rat coil (Doety scientic, US). A 2D balanced steady state imaging sequences were performed every 2 s acquiring 40 images in total initiated at the start of injection with a flip angle=15º, TR/TE = 4.8 ms/2.4 ms, sw = 20kHz, FOV=60x60 mm and a 32 x 32 matrix and an axial slice thickness of 10 mm covering both kidneys. A standard 3D gradient echo sequence was used for thermal 23Na MRI, with TR/TE 50 ms/2 ms, sw = 10kHz, matrix 32 x 32 x 8, FOV 60 mm x 60 mm x 60 mm, with 32 number of transients. Regions-of-interests of left and right kidney cortex, medulla and papilla were manually segmented in order to measure the mean intrarenal urea distribution and blood perfusion, and a region inside the abdominal aorta was used to obtain the arterial input curve. The renal blood flow was estimated by the area under curve (AUC). After scanning; blood sample, kidney tissue and urine were collected for determination of injury parameters.All rats administered with STZ developed sustained hyperglycemia within 48h. A significant intrarenal cortico-medullary gradient in urea (p<0.0001) was found in both diabetic and control animals, concomitant with a similar cortico-medullary increase in sodium distribution (p<0.0001) (Figure 1). However, there is no significant difference in these gradients between the two groups (Figure 2). The cortical blood perfusion was also similar in the two groups (Figure 3) although the diabetic kidneys showed significant hypertrophy compared to controls (0.93±0.02 versus 0.78±0.03g, p=0.0006).This study demonstrates significant cortico-medullary urea and sodium gradients in both control and diabetic rats using hyperpolarized MR, similarly to what previously has been described using invasive techniques¹. Von Morze et al³, have previously reported hyperpolarized urea as a promising maker for investigating intrarenal distribution of urea during diuresis. The finding of similar intrarenal gradients of urea and sodium in both control and early diabetes imply, that the deranged O₂ metabolism in the diabetic kidney², efficiency may drive the development of intrarenal hypoxia and may be a mechanism for the onset and progression of chronic kidney disease.This study highlights the potential of combining ²³Na, hyperpolarized ¹³C urea and standard ¹H anatomical and functional MR thus providing a more complete overview of functional parameters that may influence normal kidney function and contribute to development of chronic kidney disease.