Hemodialysis Patients with Cardiovascular Disease Reveal Increased Tissue Na+ Deposition.

Abstract

BACKGROUND:

The relationship between Na+ balance and cardiovascular disease (CVD) in hemodialysis (HD) patients is not yet fully understood. We hypothesized that HD patients co-diagnosed with CVD show increased tissue Na+ accumulation compared to HD patients without CVD.

METHODS:

In our observational study, 52 HD patients were divided into a group with (23 subjects) or without (29 subjects) a positive history of cardiovascular events. We used 23Na-magnetic resonance imaging (23Na-MRI) at 3.0 Tesla to quantify Na+ content in skin and muscle of both groups directly before and after HD. Additionally, total body fluid distribution was determined by bioimpedance spectroscopy (BIS) and laboratory parameters were assessed.

RESULTS:

Compared to HD patients without CVD, 23Na-MRI detected an increased Na+ content in skin (21.7 ± 7.3 vs. 30.2 ± 9.8 arbitrary units (a.u.), p < 0.01) and muscle tissue (21.5 ± 3.6 vs. 24.7 ± 6.0 a.u., p < 0.05) in patients with previous CVD events. Simultaneously measured fluid amount by BIS, includingexcess extracellular water (1.8 ± 1.7 vs. 2.2 ± 1.7 L, p = 0.44), was not significantly different between both groups. Tissue Na+ accumulation in HD-CVD patients was paralleled by a higher plasma concentration of the inflammation marker interleukin-6 (5.1, IQR 5.8 vs. 8.5, IQR 7.9 pg/mL, p < 0.05).

CONCLUSION:

In our cohort, HD patients with CVD showed higher tissue Na+ content than HD patients without CVD, while no difference in body water distribution could be detected between both groups. Our findings provide evidence that the history of a cardiovascular event is associated with disturbances in tissue Na+ content in HD patients.

• Authors: Anna-Carolina Friedrich, Peter Linz, Armin M Nagel, Daniela Rosenhauer, Stephan Horn, Mario Schiffer, Michael Uder, Christoph Kopp, Anke Dahlmann
• Journal: Kidney & blood pressure research (Kidney Blood Press Res) Vol. 47 Issue 3 Pg. 185-193 ( 2022) ISSN: 1423-0143 [Electronic] Switzerland
• PMID: 34915510 (Publication Type: Journal Article, Observational Study)
• Copyright: © 2021 The Author(s). Published by S. Karger AG, Basel.

Chemical References

• Sodium

Topics

• Cardiovascular Diseases
• Humans
• Kidney Failure, Chronic (complications, therapy)
• Magnetic Resonance Imaging (methods)
• Renal Dialysis
• Skin
• Sodium