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Tissue sodium stores in peritoneal dialysis and hemodialysis patients determined by 23-sodium magnetic resonance imaging

Item Type:Article
Title:Tissue sodium stores in peritoneal dialysis and hemodialysis patients determined by 23-sodium magnetic resonance imaging
Creators Name:Sahinoz, M. and Tintara, S. and Deger, S.M. and Alsouqi, A. and Crescenzi, R.L. and Mambungu, C. and Vincz, A. and Mason, O. and Prigmore, H.L. and Guide, A. and Stewart, T.G. and Harrison, D. and Luft, F.C. and Titze, J. and Alp Ikizler, T.
Abstract:BACKGROUND: Tissue sodium content in patients on maintenance hemodialysis (MHD) and peritoneal dialysis (PD) were previously explored using (23)Sodium magnetic resonance imaging ((23)NaMRI). Larger studies would provide a better understanding of sodium stores in patients on dialysis as well as the factors influencing this sodium accumulation. METHODS: In this cross-sectional study, we quantified the calf muscle and skin sodium content in 162 subjects (10 PD, 33 MHD patients, and 119 controls) using (23)NaMRI. Plasma levels of interleukin-6 (IL-6) and high-sensitivity C-reactive protein (hsCRP) were measured to assess systemic inflammation. Sixty-four subjects had repeat (23)NaMRI scans that were analyzed to assess the repeatability of the (23)NaMRI measurements. RESULTS: Patients on MHD and PD exhibited significantly higher muscle and skin sodium accumulation compared to controls. African American patients on dialysis exhibited greater muscle and skin sodium content compared to non-African Americans. Multivariable analysis showed that older age was associated with both higher muscle and skin sodium. Male sex was also associated with increased skin sodium deposition. Greater ultrafiltration was associated with lower skin sodium in patients on PD (Spearman's rho=-0.68, P = 0.035). Higher plasma IL-6 and hsCRP levels correlated with increased muscle and skin sodium content in the overall study population. Patients with higher baseline tissue sodium content exhibited greater variability in tissue sodium stores on repeat measurements. CONCLUSIONS: Our findings highlight greater muscle and skin sodium content in dialysis patients compared to controls without kidney disease. Tissue sodium deposition and systemic inflammation seen in dialysis patients might influence one another bidirectionally.
Keywords:Chronic Hemodialysis, Dialysis, Inflammation, Magnetic Resonance Imaging, Peritoneal Dialysis
Source:Nephrology Dialysis Transplantation
Publisher:Oxford University Press
Page Range:gfaa350
Date:22 December 2020
Official Publication:https://doi.org/10.1093/ndt/gfaa350
PubMed:View item in PubMed

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