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- Title
Effects of pediatric chronic kidney disease and its etiology on tissue sodium concentration: a pilot study.
- Authors
Salerno, Fabio R.; Akbari, Alireza; Lemoine, Sandrine; Scholl, Timothy J.; McIntyre, Christopher W.; Filler, Guido
- Abstract
Background: Sodium-23 magnetic resonance imaging (23Na MRI) allows non-invasive assessment of tissue sodium concentration ([Na+]). Age and chronic kidney disease (CKD) are associated with increased tissue [Na+] in adults, but limited information is available pertaining to children and adolescents. We hypothesized that pediatric CKD is associated with altered tissue [Na+] compared to healthy controls. Methods: This was a case–control exploratory study on healthy children and adults and pediatric CKD patients. Study participants underwent an investigational visit, blood/urine biochemistry, and leg 23Na MRI for tissue [Na+] quantification (whole leg, skin, soleus muscle). CKD was stratified by etiology and patients' tissue [Na+] was compared against healthy controls by computing individual Z-scores. An absolute Z-score > 1.96 was deemed to deviate significantly from the mean of healthy controls. Pearson correlation was used to compute the associations between tissue [Na+] and kidney function. Results: A total of 36 pediatric participants (17 healthy, 19 CKD) and 19 healthy adults completed the study. Healthy adults had significantly higher tissue [Na+] compared with pediatric groups; conversely, no significant differences were found between healthy children/adolescents and CKD patients. Four patients with glomerular disease and one kidney transplant recipient due to atypical hemolytic-uremic syndrome had elevated whole-leg [Na+] Z-scores. Reduced whole-leg [Na+] Z-scores were found in two patients with tubular disorders (Fanconi syndrome, proximal–distal renal tubular acidosis). All tissue [Na+] measures were significantly associated with proteinuria and hypoalbuminemia. Conclusions: Depending on etiology, pediatric CKD was associated with either increased (glomerular disease) or reduced (tubular disorders) tissue [Na+] compared with healthy controls. A higher resolution version of the Graphical abstract is available as Supplementary information.
- Subjects
SODIUM metabolism; CHRONIC kidney failure; PILOT projects; CASE-control method; COMPARATIVE studies; PEARSON correlation (Statistics); PROTEINURIA; FANCONI syndrome; INBORN errors of metabolism; RENAL tubular transport disorders; CHILDREN
- Publication
Pediatric Nephrology, 2023, Vol 38, Issue 2, p499
- ISSN
0931-041X
- Publication type
Article
- DOI
10.1007/s00467-022-05600-7