Modification of Dialysate Na+ Concentration but not Ultrafiltration or Dialysis Treatment Time Affects Tissue Na+ Deposition in Patients on Hemodialysis.
Kopp C, Kittler L, Linz P, Kannenkeril D, Horn S, Chazot C, Schiffer M, Uder M, Nagel AM, Dahlmann A (2024)
Publication Language: English
Publication Type: Journal article
Publication year: 2024
Journal
Book Volume: 9
Pages Range: 1310-1320
Journal Issue: 5
DOI: 10.1016/j.ekir.2024.02.002
Abstract
INTRODUCTION: Tissue Na+ overload is present in patients receiving hemodialysis (HD) and is associated with cardiovascular mortality. Strategies to actively modify tissue Na+ amount in these patients by adjusting the HD regimen have not been evaluated. METHODS: In several substudies, including cross-sectional analyses (n = 75 patients on HD), a cohort study and a cross-over interventional study (n = 10 patients each), we assessed the impact of ultrafiltration (UF) volume, prolongation of dialysis treatment time, and modification of dialysate Na+ concentration on tissue Na+ content using 23Na magnetic resonance imaging (23Na-MRI). RESULTS: In the cross-sectional analysis of our patients on HD, differences in dialysate sodium concentration ([Na+]) were associated with changes in tissue Na+ content, whereas neither UF volume nor HD treatment time affected tissue Na+ amount. Skin Na+ content was lower in 17 patients on HD, with dialysate [Na+] of <138 mmol/l compared to 58 patients dialyzing at ≥138 mmol/l (20.7 ± 7.3 vs. 26.0 ± 8.8 arbitrary units [a.u.], P < 0.05). In the cohort study, intraindividual prolongation of HD treatment time was not associated with a reduction in tissue Na+ content. Corresponding to the observational data, intraindividual modification of dialysate [Na+] from 138 to 142 to 135 mmol/l resulted in concordant changes in skin Na+ (24.3 ± 7.6 vs. 26.3 ± 8.0 vs. 20.8 ± 5.6 a.u, P < 0.05 each), whereas no significant change in muscle Na+ occurred. CONCLUSION: Solely adjustment of dialysate [Na+] had a reproducible impact on tissue Na+ content. 23Na-MRI could be utilized to monitor the effectiveness of dialysate [Na+] modifications in randomized-controlled outcome trials.
Authors with CRIS profile
Christoph Kopp
Department of Medicine 4 – Nephrology and Hypertension
Lukas Kittler
Department of Medicine 4 – Nephrology and Hypertension
Peter Linz
Institute of Radiology
Mario Schiffer
Lehrstuhl für Innere Medizin IV
Michael Uder
Lehrstuhl für Diagnostische Radiologie
Armin Michael Nagel
Professur für metabolische und funktionelle MR-Bildgebung
Anke Dahlmann
Department of Medicine 4 – Nephrology and Hypertension
Involved external institutions
France (FR)
Germany (DE)How to cite
APA:
Kopp, C., Kittler, L., Linz, P., Kannenkeril, D., Horn, S., Chazot, C.,... Dahlmann, A. (2024). Modification of Dialysate Na+ Concentration but not Ultrafiltration or Dialysis Treatment Time Affects Tissue Na+ Deposition in Patients on Hemodialysis. Kidney International Reports, 9(5), 1310-1320. https://doi.org/10.1016/j.ekir.2024.02.002
MLA:
Kopp, Christoph, et al. "Modification of Dialysate Na+ Concentration but not Ultrafiltration or Dialysis Treatment Time Affects Tissue Na+ Deposition in Patients on Hemodialysis." Kidney International Reports 9.5 (2024): 1310-1320.
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