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Kidney Week

Abstract: FR-PO0578

Sweat Analysis via Pilocarpine-Iontophoresis in Patients with CKD

Session Information

Category: Fluid, Electrolytes, and Acid-Base Disorders

  • 1102 Fluid, Electrolyte, and Acid-Base Disorders: Clinical

Authors

  • Shoumariyeh, Tarik, Medizinische Universitat Wien, Vienna, Austria
  • Logar, Florian, Academic Teaching Hospital of St. John of God, Vienna, Austria
  • Hofer, Johannes, Medizinische Universitat Wien, Vienna, Austria
  • Schmetterer, Klaus G, Medizinische Universitat Wien, Vienna, Austria
  • Gruber, Saskia, Medizinische Universitat Wien, Vienna, Austria
  • Saemann, Marcus D., Wilhelminenspital, Vienna, Austria
  • Kaltenecker, Christopher, Medizinische Universitat Wien, Vienna, Austria
  • Kovarik, Johannes J., Medizinische Universitat Wien, Vienna, Austria
Background

Excretion of sodium and water through the skin as sweat represents a regulatory mechanism of electrolyte- and fluid balance. Since patients with chronic kidney disease (CKD) exhibit increased skin sodium content, we investigated the feasibility of sweat testing as a novel experimental tool to provide a more complete assessment of fluid- and sodium status.

Methods

In this cross-sectional feasibility study, we applied pilocarpine iontophoresis to induce sweat testing in 58 patients across various stages of CKD including kidney transplant recipients and a healthy control cohort (n=6) to investigate possible effects of CKD and transplantation status on sweat weight and sodium concentration. Due to non-linear relationships, we modeled our data using polynomial regression.

Results

Decline of kidney function showed a significant association with lower sweat weight: adj R^2= 0.2278, F(2, 61) = 10.29, p = 0.0001. Sweat sodium concentrations were increased in moderate CKD, however, this effect was lost in end-stage kidney disease: adj R^2 = 0.3701, F(4, 59) = 10.26, p = 2.261e-06.

Conclusion

Diagnostic sweat analysis represents an innovative, non-invasive option for a more thorough investigation of sodium- and fluid homeostasis in CKD. Lower sweat weight and higher sweat sodium concentrations represent a unique feature of CKD patients with potential therapeutic implications.

Digital Object Identifier (DOI)