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Abstract: PO1179

Effect of Intradialytic Exercise on the Removal of Tissue Sodium During Hemodialysis

Session Information

Category: Dialysis

  • 701 Dialysis: Hemodialysis and Frequent Dialysis

Authors

  • Fang, Hsin-Yu, University of Illinois at Urbana-Champaign, Urbana, Illinois, United States
  • Perez, Luis M., University of Illinois at Urbana-Champaign, Urbana, Illinois, United States
  • Larsen, Ryan J., University of Illinois at Urbana-Champaign, Urbana, Illinois, United States
  • King, Alexis, University of Illinois at Urbana-Champaign, Urbana, Illinois, United States
  • Burrows, Brett, University of Illinois at Urbana-Champaign, Urbana, Illinois, United States
  • Wilund, Kenneth Robert, University of Illinois at Urbana-Champaign, Urbana, Illinois, United States
Background

Emerging evidence using 23Na-MRI shows that sodium can be stored in the skin and muscle. Hemodialysis (HD) patients appear to have higher tissue sodium concentration ([Na+]) compared to healthy controls, though tissue [Na+] appears to be partially reduced during HD. In this study, we thus aimed to determine whether intradialytic cycling (IDC) potentiates the removal of tissue [Na+] during HD.

Methods

Seven HD patients (sex: 57% male; age: 60±12 y; BMI: 36±10 kg/m2; spKt/V: 1.4±.32; dialysate [Na+]: 136±1.90 mEq/L; UFR: 7.7±3.4 mL/kg/hr; thrice-weekly HD) underwent 23Na-MRI scans (3T system) before and after HD, on both a control (CON) and exercise (EX) day. Patients performed 30 minutes of IDC during the first hour of HD on the EX day and received standard care on the CON day. [Na+] of the medial (MG) and lateral (LG) gastrocnemius, soleus (Sol), tibialis anterior (TA), and the whole lower leg (WL) were quantified from MRI images by trend analysis. Plasma [Na+] was also assessed by a colorimetric enzymatic assay (Piccolo). Repeated measures ANOVA was used to examine changes in muscle and plasma [Na+] between the EX and CON treatments from pre to post HD.

Results

There was a significant treatment by time interaction for [Na+] in WL (P=.036) and Sol (P=.016), with the EX treatment attenuating the drop in [Na+] during HD compared to the CON condition in both WL and Sol (Figure1A-B). [Na+] of MG (P=.002), LG (P<.001),TA (P<.001), and plasma (P=.042) were reduced during HD, but these changes did not differ by treatment (treatment x time interaction P = N.S. for all; Figure1C-F).

Conclusion

Contrary to our hypothesis, it appears that IDC may attenuate, instead of potentiate, the magnitude of tissue [Na+] removed during HD. However, this was not a consistent finding across all muscle beds analyzed. More studies are needed to examine if this result is a manifestation of the timing of MRI, the limited sample size, or other factors.

Funding

  • Private Foundation Support