Skin Sodium Content Linked to Heart Problems in Patients with Kidney Disease

Article ID: 668385

Released: 27-Jan-2017 9:00 AM EST

Source Newsroom: American Society of Nephrology (ASN)

Highlight• Elevated sodium content in the skin correlates closely with left ventricular hypertrophy in patients with chronic kidney disease.

Heart disease is a leading cause of death in individuals with chronic kidney disease.

Newswise — Washington, DC (February 2, 2017) — New research may provide insights concerning the cause of changes in the heart’s structure that often occur in patients with chronic kidney disease (CKD). The findings, which appear in an upcoming issue of the Journal of the American Society of Nephrology (JASN), suggest that treatments targeting skin sodium may help protect CKD patients’ heart health.

Individuals with CKD are at elevated risk of developing heart problems and dying from cardiovascular causes. At least in part, these increased risks are related to a high prevalence and severity of left ventricular hypertrophy (LVH), an enlargement and thickening of the walls of the heart’s left ventricle. The cause of LVH in patients with CKD is unclear, although some studies suggest that excess sodium intake may play a role.

Recent research indicates that tissues such as skin and muscle may store sodium. Markus Schneider, MD (University of Erlangen-Nuremberg, in Germany) and his colleagues wondered whether sodium deposition in these newly identified sodium stores is related to the degree of LVH in CKD patients. Using a technique called 23Na-magnetic resonance imaging, the team measured skin sodium content at the level of the calf in 99 patients with mild to moderate CKD. The researchers also assessed total body water levels, 24-hour blood pressure, and left ventricular mass.

Skin sodium content, but not total body water, correlated with systolic blood pressure. Moreover, skin sodium content correlated more strongly than total body water did with left ventricular mass. Results from additional analyses suggested that skin sodium is a strong explanatory variable of left ventricular mass independent of blood pressure or total body water.

“We believe that skin sodium reflects deposition of excess sodium,” said Dr. Schneider. “Our finding of a strong relationship between skin sodium and changes in the structure of the heart suggests that interventions that reduce skin sodium content—for example dietary sodium restriction or medications that lead to increased sodium excretion—may have beneficial effects on the heart in patients with kidney disease.”

Study co-authors include; Ulrike Raff, MD; Christoph Kopp, MD; Johannes Scheppach, MD; Sebastian Toncar, MD; Christoph Wanner, MD; Georg Schlieper, MD; Turgay Saritas, MD; Jürgen Floege, MD; Matthias Schmid, MD; Anna Birukov; Anke Dahlmann, MD; Peter Linz, PhD; Rolf Janka, MD; Michael Uder, MD; Roland Schmieder, MD; Jens Titze, MD; and Kai-Uwe Eckardt, MD. The study is a substudy of the German Chronic Kidney Disease (GCKD) study.

Disclosures: The study was supported by Fresenius Medical Care, Bad Homburg, Germany, the Bundesministerium für Bildung und Forschung, Germany, and the Kuratorium für Heimdialyse und Nierentransplantation e.V. – Stiftung Präventivmedizin, Germany.

The article, entitled “Skin Sodium Is Closely Related to Left Ventricular Hypertrophy in Chronic Kidney Disease,” will appear online at http://jasn.asnjournals.org/ on February 2, 2017, doi: 10.1681/ASN.2016060662.

The content of this article does not reflect the views or opinions of The American Society of Nephrology (ASN). Responsibility for the information and views expressed therein lies entirely with the author(s). ASN does not offer medical advice. All content in ASN publications is for informational purposes only, and is not intended to cover all possible uses, directions, precautions, drug interactions, or adverse effects. This content should not be used during a medical emergency or for the diagnosis or treatment of any medical condition. Please consult your doctor or other qualified health care provider if you have any questions about a medical condition, or before taking any drug, changing your diet or commencing or discontinuing any course of treatment. Do not ignore or delay obtaining professional medical advice because of information accessed through ASN. Call 911 or your doctor for all medical emergencies.Since 1966, ASN has been leading the fight to prevent, treat, and cure kidney diseases throughout the world by educating health professionals and scientists, advancing research and innovation, communicating new knowledge, and advocating for the highest quality care for patients. ASN has nearly 17,000 members representing 112 countries. For more information, please visit www.asn-online.org or contact the society at 202-640-4660.# # #


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