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Abstract: SA-OR056

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

Session Information

Category: Hypertension and CVD

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

Authors

  • Friedrich, Anna-Carolina, Dept. of Nephrology and Hypertension, Erlangen, Germany
  • Kopp, Christoph, Dept. of Nephrology and Hypertension, Erlangen, Germany
  • Linz, Peter, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany
  • Nagel, Armin M., University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany
  • Titze, Jens, Duke - National University of Singapore, Singapore, Singapore
  • Dahlmann, Anke, Dept. of Nephrology and Hypertension, Erlangen, Germany
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).
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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.