Abstract-Either in research or in clinical practice, the exploration of renal oxidative metabolism is limited by the lack of noninvasive measurement. Positron-emission tomography using carbon-11 acetate may estimate tissue oxidative metabolism by measuring acetate turnover in the Krebs cycle. Although extensively studied in cardiology, this method has never been validated for renal oxidative metabolism measurement. The aim of this study is the validation of acetate turnover compared with the invasive renal oxygen consumption measurement. Renal oxygen consumption and tubular sodium reabsorption were measured invasively in 10 anesthetized pigs. Simultaneously, acetate turnover was estimated by the clearance of carbon-11 acetate in the renal cortex, after a 166-MBq injection of carbon-11 acetate. Renal oxidative metabolism was measured under various conditions induced by mechanical and pharmacological interventions. Renal oxygen consumption and acetate turnover varied on a wide range from 0.05 to 0.29 mmol min Ϫ1 (Ͼ5-fold) and from 0.025 to 0.188 minutes Ϫ1 (Ͼ7-fold), respectively. Acetate turnover was very significantly correlated with renal oxygen consumption (PϽ0.0001; Rϭ0.82) and tubular sodium reabsorption (Pϭ0.001; Rϭ0.67). This study demonstrates that acetate turnover measures renal oxidative metabolism noninvasively and quantitatively, consistent with changes in tubular sodium reabsorption. This method may be applied to assess oxidative metabolism in animal models and in humans. Key Words: cell respiration Ⅲ kidney Ⅲ positron-emission tomography Ⅲ carbon-11 acetate Ⅲ oxygen consumption K idneys have the highest basal oxidative metabolism, representing 10% of basal body metabolism for 1% of the body weight. 1 This very high oxidative metabolism is mainly involved in sodium reabsorption, and changes in renal oxidative metabolism correlate closely with changes in sodium reabsorption. 2,3 It is, therefore, most likely that renal oxidative metabolism could be changed significantly in chronic renal diseases, ischemic nephropathy, or by drugs, such as diuretics.Until now, changes in oxidative were studied by the measurement of oxygen consumption in isolated tubules or by the direct measurement of renal oxygen consumption using arteriovenous difference. 3 Those methods are invasive and cannot be applied in humans. Therefore, the exploration of renal oxidative metabolism changes induced during human diseases is limited.Positron-emission tomography (PET) is an imaging modality that provides quantitative and noninvasive measurements of functional parameters. After carbon-11-labeled acetate intravenous injection, renal cells extract acetate from the blood. Then, acetate is consumed in the Krebs cycle, depending on the intensity of oxidative metabolism, and is rejected in blood as 11 CO 2 . 4 Using this principle, acetate turnover measurement by PET has been extensively used in cardiology to evaluate heart viability. 5 Shreve et al 6 showed that renal acetate turnover measured by PET was markedly changed in human renal ...