Hemodialysis Patients with Cardiovascular Disease Reveal Increased Tissue Na+ Deposition

• Published in: Kidney & blood pressure research Vol. 47; no. 3; pp. 185 - 193
• Main Authors: Friedrich, Anna-Carolina, Linz, Peter, Nagel, Armin M., Rosenhauer, Daniela, Horn, Stephan, Schiffer, Mario, Uder, Michael, Kopp, Christoph, Dahlmann, Anke
• Format: Journal Article
• Language: English
• Published: Basel, Switzerland S. Karger AG 01.03.2022; Karger Publishers
• Subjects: Age; Bioaccumulation; Blood pressure; Body fluids; Body water; Cardiovascular disease; Cardiovascular Diseases; Chemical vapor deposition; Heart diseases; Heart failure; Hemodialysis; Homeostasis; Humans; Hypertension; Hypotheses; Interleukin 6; Interleukins; Kidney Failure, Chronic - complications; Kidney Failure, Chronic - therapy; Magnetic resonance imaging; Magnetic Resonance Imaging - methods; Muscles; Patients; Renal Dialysis; Research Article; Skin; Sodium; Spectroscopy; Spectrum analysis; Tissues; Water distribution; Water engineering; United States > US; Germany; Cardiovascular disease; Tissue Na+; 23Na-magnetic resonance imaging; Hemodialysis
• ISSN: 1420-4096; 1423-0143; 1423-0143
• DOI: 10.1159/000520821

Background: The relationship between Na + balance and cardiovascular disease (CVD) in hemodialysis (HD) patients is not yet fully understood. We hypothesized that HD patients co-diagnosed with CVD show increased tissue Na + accumulation compared to HD patients without CVD. Methods: In our observational study, 52 HD patients were divided into a group with (23 subjects) or without (29 subjects) a positive history of cardiovascular events. We used 23 Na-magnetic resonance imaging ( 23 Na-MRI) at 3.0 Tesla to quantify Na + content in skin and muscle of both groups directly before and after HD. Additionally, total body fluid distribution was determined by bioimpedance spectroscopy (BIS) and laboratory parameters were assessed. Results: Compared to HD patients without CVD, 23 Na-MRI detected an increased Na + content in skin (21.7 ± 7.3 vs. 30.2 ± 9.8 arbitrary units (a.u.), p < 0.01) and muscle tissue (21.5 ± 3.6 vs. 24.7 ± 6.0 a.u., p < 0.05) in patients with previous CVD events. Simultaneously measured fluid amount by BIS, includingexcess extracellular water (1.8 ± 1.7 vs. 2.2 ± 1.7 L, p = 0.44), was not significantly different between both groups. Tissue Na + accumulation in HD-CVD patients was paralleled by a higher plasma concentration of the inflammation marker interleukin-6 (5.1, IQR 5.8 vs. 8.5, IQR 7.9 pg/mL, p < 0.05). Conclusion: In our cohort, HD patients with CVD showed higher tissue Na + content than HD patients without CVD, while no difference in body water distribution could be detected between both groups. Our findings provide evidence that the history of a cardiovascular event is associated with disturbances in tissue Na + content in HD patients.