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Elevated tissue sodium deposition in patients with type 2 diabetes on hemodialysis detected by (23)Na magnetic resonance imaging

Item Type:Article
Title:Elevated tissue sodium deposition in patients with type 2 diabetes on hemodialysis detected by (23)Na magnetic resonance imaging
Creators Name:Kopp, C. and Linz, P. and Maier, C. and Wabel, P. and Hammon, M. and Nagel, A.M. and Rosenhauer, D. and Horn, S. and Uder, M. and Luft, F.C. and Titze, J. and Dahlmann, A.
Abstract:Long-term elevated blood sugar levels result in tissue matrix compositional changes in patients with diabetes mellitus type 2 (T2DM). We hypothesized that hemodialysis patients with T2DM might accumulate more tissue sodium than control hemodialysis patients. To test this, (23)Na magnetic resonance imaging ((23)Na MRI) was used to estimate sodium in skin and muscle tissue in hemodialysis patients with or without T2DM. Muscle fat content was estimated by (1)H MRI and tissue sodium content by (23)Na MRI pre- and post-hemodialysis in ten hemodialysis patients with T2DM and in 30 matched control hemodialysis patients. We also assessed body fluid distribution with the Body Composition Monitor. (1)H MRI indicated a tendency to higher muscle fat content in hemodialysis patients with T2DM compared to non-diabetic hemodialysis patients. (23)Na MRI indicated increased sodium content in muscle and skin tissue of hemodialysis patients with T2DM compared to control hemodialysis patients. Multi-frequency bioimpedance was used to estimate extracellular water (ECW), and excess ECW in T2DM hemodialysis patients correlated with HbA1c levels. Sodium mobilization during hemodialysis lowered muscle sodium content post-dialysis to a greater degree in T2DM hemodialysis patients than in control hemodialysis patients. Thus, our findings provide evidence that increased sodium accumulation occurs in hemodialysis patients with T2DM and that impaired serum glucose metabolism is associated with disturbances in tissue sodium and water content.
Keywords:Diabetes, Hemodialysis, (23)Na MRI, Tissue Na(+)
Source:Kidney International
ISSN:0085-2538
Publisher:Nature Publishing Group (U.S.A.)
Volume:93
Number:5
Page Range:1191-1197
Date:May 2018
Official Publication:https://doi.org/10.1016/j.kint.2017.11.021
PubMed:View item in PubMed

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