Kidney Week

Abstract: SA-OR056

Elevated Tissue Na+ Deposition in Hemodialysis Patients with Cardiovascular Disease Detected by 23Na-Magnetic Resonance Imaging

Session Information

• Hypertension and CVD: Epidemiology and Outcomes
  October 27, 2018 | Location: 6F, San Diego Convention Center
  Abstract Time: 06:06 PM - 06:18 PM

Category: Hypertension and CVD

• 1402 Hypertension and CVD: Clinical, Outcomes, and Trials

Authors

• Friedrich, Anna-Carolina, Dept. of Nephrology and Hypertension, Erlangen, Germany

Anna-Carolina Friedrich

• Kopp, Christoph, Dept. of Nephrology and Hypertension, Erlangen, Germany

Christoph Kopp,

• Linz, Peter, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany

Peter Linz,

• Nagel, Armin M., University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany

Armin M. Nagel,

• Titze, Jens, Duke - National University of Singapore, Singapore, Singapore

Jens Titze,

• Dahlmann, Anke, Dept. of Nephrology and Hypertension, Erlangen, Germany

Anke Dahlmann,

Background

Disturbances in Na⁺ homeostasis with accumulation of Na+ in tissues are present in salt sensitive hypertension and correlate with left ventricular hypertrophy. Tissue Na⁺ distribution could be recently visualized in vivo by ²³Na-magnetic resonance imaging (²³Na-MRI). We used ²³Na-MRI to quantify Na⁺ in skin and muscle of hemodialysis (HD) patients either with or without concomitant cardiovascular disease (CVD). We hypothesized that tissue Na⁺ might accumulate to a higher extent in HD patients co-diagnosed with CVD.

Methods

We used ²³Na-MRI at 3.0 Tesla to quantify Na⁺ content in skeletal muscle and skin of the left lower leg. We determined tissue Na⁺ content using a Na⁺ volume coil in 19 HD patients with a positive history of a CV event (MI, CABG, arrhythmia, stroke or PAD IV) and in 41 age-matched control HD patients. Additionally, total body water content, including extra- and intracellular water space, were determined using Body Composition Monitoring technique (BCM).

Results

Compared to control HD patients ²³Na-MRI detected an increased Na⁺ content in muscle tissue (20.97 ± 3.60 vs. 24.59 ± 7.10 mmol/L, p<0.05) and skin tissue (21.95 ± 7.26 vs. 29.80 ± 10.91 mmol/L, p<0.05) of HD+CVD patients. Simultaneously measured excess extracellular water content detected by BCM was significantly higher in the HD+CVD group (1.17 ± 1.48 vs. 2.31 ± 1.61 liter, p<0.05).
.

Conclusion

²³Na-MRI detected increased Na⁺ in muscle and skin tissue as well as higher excess extracellular water content in HD+CVD patients. Our findings provide evidence that the history of a cardiovascular event is associated with disturbances in tissue Na⁺ and water content in HD patients.