Abstract
Introduction: Chronic kidney disease (CKD) engenders salt-sensitive hypertension. Whether or not tissue Nathorn accumulation is increased in CKD patients remains uncertain. How tissue Nathorn is affected after renal transplantation has not been assessed. Methods: We measured tissue Na+ amount in 31 CKD patients (stage 5) and prospectively evaluated tissue Na+ content at 3 and 6 months, following ...
Abstract
Introduction: Chronic kidney disease (CKD) engenders salt-sensitive hypertension. Whether or not tissue Nathorn accumulation is increased in CKD patients remains uncertain. How tissue Nathorn is affected after renal transplantation has not been assessed. Methods: We measured tissue Na+ amount in 31 CKD patients (stage 5) and prospectively evaluated tissue Na+ content at 3 and 6 months, following living-donor kidney transplantation. Additionally, pre- and post-transplantation data were compared to 31 age- and sex-matched control subjects. Na-23-magnetic resonance imaging (Na-23-MRI) was used to quantify muscle and skin Na+ of the lower leg and water distribution was assessed by bioimpedance spectroscopy. Results: Compared to control subjects, CKD patients showed increased muscle (20.7 +/- 5.0 vs. 15.5 +/- 1.8 arbitrary units [a.u.], P < 0.001) and skin Na+ content (21.4 +/- 7.7 vs. 15.0 +/- 2.3 a.u., P < 0.001), whereas plasma Na+ concentration did not differ between groups. Restoration of kidney function by successful renal transplantation was accompanied by mobilization of tissue Na+ from muscle (20.7 +/- 5.0 vs. 16.8 +/- 2.8 a.u., P < 0.001) and skin tissue (21.4 +/- 7.7 vs. 16.8 +/- 5.2 a.u., P < 0.001). The reduction of tissue Na+ after transplantation was associated with improved renal function, normalization of blood pressure as well as an increase in lymphatic growth-factor concentration (vascular endothelial growth factor C [VEGF-C] 4.5 +/- 1.8 vs. 6.7 +/- 2.7 ng/ml, P < 0.01). Conclusions: Tissue Na+ accumulation in predialysis patients with CKD was almost completely reversed to the level of healthy controls after successful kidney transplantation.
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