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Abstract: SA-OR033

Sodium Concentration in Tissues of Dialysis Patients

Session Information

Category: Fluid and Electrolytes

  • 902 Fluid and Electrolytes: Clinical

Authors

  • Qirjazi, Elena, Western University, London, Ontario, Canada
  • Akbari, Alireza, Western University, London, Ontario, Canada
  • Scholl, Timothy J., Western University, London, Ontario, Canada
  • McIntyre, Christopher W., London Health Sciences Centre, London, Ontario, Canada
Background

Dialysis patients are unable to fully remove sodium (23Na). Thus, 23Na is buffered in the skin, muscle and skeleton (osmotically inactive, but not biologically inert). We measured 23Na content in these reservoirs using novel 23Na MRI, in dialysis patients and healthy controls.

Methods

We undertook a pilot cross-sectional study of 26 subjects (10 controls and 16 dialysis - 9 peritoneal dialysis and 7 hemodialysis - patients). Subjects participated in a study session, which included collection of baseline information, bloodwork and a 23Na MRI study using a multinuclear-capable 3.0T MRI (Discovery MR750, General Electric Healthcare). An axial proton T1-weighted fast-low-angle-shot sequence was acquired to delineate the anatomy; followed by a 23Na MR image obtained with a custom-made lower-leg 23Na coil and 23Na-optimized pulse sequence (DA-3DPR). Maps of absolute tissue 23Na concentration were generated using calibration vials of known 23Na concentration included in the field-of-view. Four regions of interest were drawn, highlighting different tissues: 1) pre-tibial skin, 2) posterior leg skin (included because 23Na distribution in skin was inhomogeneous), 3) soleus muscle, and 4) tibia.

Results

23Na concentrations in the different tissues for both groups are shown in Fig. 1. Dialysis patients had statistically significant higher 23Na levels in all four regions (p<0.05). Dialysis modality and gender did not have a significant effect.

Conclusion

Dialysis patients have significantly higher 23Na level in their skin, muscle and bone compared to healthy controls.

Fig. 1: A: 23Na concentration map of the lower leg and calibration vials for a dialysis patient. B: 23Na concentration in different tissues in dialysis patients and controls. Error bars = standard deviation. * = statistically significant differences (p<0.05)