Tissue sodium accumulation and peripheral insulin sensitivity in maintenance hemodialysis patients

Deger, Serpil Muge; Wang, Ping; Fissell, Rachel B.; Ellis, Charles D.; Booker, Cindy; Shi, Feng; Morse, Jennifer; Stewart, Thomas G.; Gore, John C.; Siew, Edward D.; Titze, Jens; İkizler, T. Alp

doi:10.1002/jcsm.12179

Cited by 31 publications

(21 citation statements)

References 20 publications

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“…Kopp et al [20] observed that, despite comparable TBW assessed by BIS, ECV was higher in HD patients with type II diabetes mellitus as compared to non-diabetics, whereas intracellular volume was lower. Also, skin and muscle sodium content, assessed by 23 Na MRI, were higher in the diabetics. Of interest, ECV correlated with HbA1C in the diabetics.…”

Section: Non-cardiovascular Factors On Abnormalities In Fluid Statusmentioning

confidence: 86%

“…It has been shown that using 23 Na MRI that HD is able to mobilize skin as well as muscle sodium [20], although the efficacy may be dependent upon local or systemic regulatory mechanisms, as evidenced by the inverse relation between skin sodium and vascular endothelial growth factor levels [16,21]. At first glance, the nonosmotic storage of sodium would seem to be a beneficial adaptation mechanism to buffer extremes in sodium intake.…”

Section: Non-osmotic Sodium Storagementioning

confidence: 99%

“…At first glance, the nonosmotic storage of sodium would seem to be a beneficial adaptation mechanism to buffer extremes in sodium intake. However, this may be offset by adverse effects such as the induction of proinflammatory effects [7,17,18,22] and insulin resistance [23]. In addition, interstitial sodium stores may possibly induce vascular dysfunction [24].…”

Section: Non-osmotic Sodium Storagementioning

confidence: 99%

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Body Fluids in End-Stage Renal Disease: Statics and Dynamics

Kooman

Sande²

2018

Blood Purif

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Background: Abnormalities in fluid status in hemodialysis (HD) patients are highly prevalent and are related to adverse outcomes. Summary: The inherent discontinuity of the HD procedure in combination with an often compromised cardiovascular response is a major contributor to this phenomenon. In addition, systemic inflammation and endothelial dysfunction are related to extracellular fluid overload (FO). Underlying this relation may be factors such as hypoalbuminemia and an increased capillary permeability, leading to an altered fluid distribution between the blood volume (BV) and the interstitial fluid compartments, compromising fluid removal during dialysis. Indeed, whereas estimates of extracellular volume by bioimpedance spectroscopy are highly predictive of mortality, absolute BV assessed by the saline dilution technique was predictive of intra-dialytic morbidity. Changes in relative BV during HD are positively related to ultrafiltration rate (UFR) and, at least in some studies, negatively to FO. High UFR is also related to changes in central venous oxygen saturation (S_cvO₂), a marker for tissue perfusion. On the one hand, high UFR and more pronounced declines in S_cvO₂, but on the other hand, flat relative BV curves are also predictive of mortality; the relation between outcome which statics and dynamics of fluid status appears to be complex. Key Message: While technological developments enable the clinician to monitor statics and dynamics of fluid status and hemodynamics during HD in an accessible way, the role of technology-based interventions needs further study.

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Section: Non-cardiovascular Factors On Abnormalities In Fluid Statusmentioning

confidence: 86%

Section: Non-osmotic Sodium Storagementioning

confidence: 99%

Section: Non-osmotic Sodium Storagementioning

confidence: 99%

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Body Fluids in End-Stage Renal Disease: Statics and Dynamics

Kooman

Sande²

2018

Blood Purif

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“…A study by Brands and colleagues showed that such Na + -retaining effects may be limited to uncontrolled Type II diabetes [32]. In 11 maintenance haemodialysis patients, higher muscle sodium content was, in a similar way, associated with insulin resistance [34]. Furthermore, in the soleus muscle of salt-sensitive hypertensive Dahl rats, the RAAS was shown to activate the NF-κB pro-inflammatory pathway, inducing moderate hyperinsulinemia and insulin resistance [33].…”

Section: Na + Homeostasis and Hyperinsulinismmentioning

confidence: 99%

Tissue Sodium Content and Arterial Hypertension in Obese Adolescents

Roth

Markó

Birukov

et al. 2019

JCM

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Early-onset obesity is known to culminate in type 2 diabetes, arterial hypertension and subsequent cardiovascular disease. The role of sodium (Na+) homeostasis in this process is incompletely understood, yet correlations between Na+ accumulation and hypertension have been observed in adults. We aimed to investigate these associations in adolescents. A cohort of 32 adolescents (13–17 years), comprising 20 obese patients, of whom 11 were hypertensive, as well as 12 age-matched controls, underwent 23Na-MRI of the left lower leg with a standard clinical 3T scanner. Median triceps surae muscle Na+ content in hypertensive obese (11.95 mmol/L [interquartile range 11.62–13.66]) was significantly lower than in normotensive obese (13.63 mmol/L [12.97–17.64]; p = 0.043) or controls (15.37 mmol/L [14.12–16.08]; p = 0.012). No significant differences were found between normotensive obese and controls. Skin Na+ content in hypertensive obese (13.33 mmol/L [11.53–14.22] did not differ to normotensive obese (14.12 mmol/L [13.15–15.83]) or controls (11.48 mmol/L [10.48–12.80]), whereas normotensive obese had higher values compared to controls (p = 0.004). Arterial hypertension in obese adolescents is associated with low muscle Na+ content. These findings suggest an early dysregulation of Na+ homeostasis in cardiometabolic disease. Further research is needed to determine whether this association is causal and how it evolves in the transition to adulthood.

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“…71,92 Furthermore, tissue sodium accumulation was shown recently to be associated with muscle structural and functional disturbances contributing to peripheral insulin resistance. 93 Tissue sodium accumulation has been observed in a number of degenerative or inflammatory pathologies that are associated with poor outcomes. [94][95][96] For example, tissue sodium and water content has been explored in a model of acute muscle atrophy obtained by unloading the calf muscles of 1 leg.…”

mentioning

confidence: 99%