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Reduction of tissue Na(+) accumulation after renal transplantation

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Item Type:Article
Title:Reduction of tissue Na(+) accumulation after renal transplantation
Creators Name:Dahlmann, A. and Linz, P. and Zucker, I. and Haag, V. and Jantsch, J. and Dienemann, T. and Nagel, A.M. and Neubert, P. and Rosenhauer, D. and Rauh, M. and Horn, S. and Müller, D.N. and Schiffer, M. and Luft, F.C. and Uder, M. and Kopp, C.
Abstract:INTRODUCTION: Chronic kidney disease (CKD) engenders salt-sensitive hypertension. Whether or not tissue Na(+) accumulation is increased in CKD patients remains uncertain. How tissue Na(+) is affected after renal transplantation has not been assessed. METHODS: We measured tissue Na(+) amount in 31 CKD patients (stage 5) and prospectively evaluated tissue Na(+) content at 3 and 6 months, following living-donor kidney transplantation. Additionally, pre- and post-transplantation data were compared to 31 age- and sex-matched control subjects. (23)Na–magnetic resonance imaging ((23)Na-MRI) was used to quantify muscle and skin Na(+) of the lower leg and water distribution was assessed by bioimpedance spectroscopy. RESULTS: Compared to control subjects, CKD patients showed increased muscle (20.7 ± 5.0 vs. 15.5 ± 1.8 arbitrary units [a.u.], P < 0.001) and skin Na+ content (21.4 ± 7.7 vs. 15.0 ± 2.3 a.u., P < 0.001), whereas plasma Na(+) concentration did not differ between groups. Restoration of kidney function by successful renal transplantation was accompanied by mobilization of tissue Na(+) from muscle (20.7 ± 5.0 vs. 16.8 ± 2.8 a.u., P < 0.001) and skin tissue (21.4 ± 7.7 vs. 16.8 ± 5.2 a.u., P < 0.001). The reduction of tissue Na(+) after transplantation was associated with improved renal function, normalization of blood pressure as well as an increase in lymphatic growth-factor concentration (vascular endothelial growth factor C [VEGF-C] 4.5 ± 1.8 vs. 6.7 ± 2.7 ng/ml, P < 0.01). CONCLUSIONS: Tissue Na+ accumulation in predialysis patients with CKD was almost completely reversed to the level of healthy controls after successful kidney transplantation.
Keywords:Chronic Kidney Disease, Kidney Transplantation, Tissue Na(+), (23)Na–Magnetic Resonance Imaging, Vascular Endothelial Growth Factor C
Source:Kidney International Reports
Page Range:2338-2347
Date:September 2021
Official Publication:https://doi.org/10.1016/j.ekir.2021.06.022
PubMed:View item in PubMed

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