ASN's Mission

To create a world without kidney diseases, the ASN Alliance for Kidney Health elevates care by educating and informing, driving breakthroughs and innovation, and advocating for policies that create transformative changes in kidney medicine throughout the world.

learn more

Contact ASN

1401 H St, NW, Ste 900, Washington, DC 20005

email@asn-online.org

202-640-4660

The Latest on X

Kidney Week

ASN / Education & Meetings / Kidney Week /

Please note that you are viewing an archived section from 2020 and some content may be unavailable. To unlock all content for 2020, please visit the archives.

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