Outcomes and predictors of skin sodium concentration in dialysis patients - Inserm - Institut national de la santé et de la recherche médicale Accéder directement au contenu
Article Dans Une Revue Clinical Kidney Journal Année : 2022

Outcomes and predictors of skin sodium concentration in dialysis patients

Résumé

BACKGROUND: Sodium-23 magnetic resonance imaging ((23)Na MRI) allows the measurement of skin sodium concentration ([Na(+)]). In patients requiring dialysis, no data are available relating to the clinical outcomes associated with skin sodium accumulation or the determinants of increasing deposition. METHODS: This was an exploratory, observational study of adult hemodialysis (HD) and peritoneal dialysis (PD) patients. Participants underwent skin [Na(+)] quantification with leg (23)Na MRI at the study's beginning. Outcomes of interest were all-cause mortality and composite all-cause mortality plus major adverse cardiovascular events. Cumulative total and event-free survival were assessed using the Kaplan-Meier survival function after stratification into skin [Na(+)] quartiles. Cox proportional hazards regression was used to model the association between skin [Na(+)] and outcomes of interest. Multiple linear regression was used to model the predictors of skin [Na(+)]. RESULTS: A total of 52 participants (42 HD and 10 PD) underwent the study procedures. The median follow-up was 529 days (interquartile range: 353-602). Increasing skin [Na(+)] quartiles were associated with significantly shorter overall and event-free survival (log-rank χ(2)(1) = 3.926, log-rank χ(2)(1) = 5.685; P for trend \textless0.05 in both instances). Skin [Na(+)] was associated with all-cause mortality \hazard ratio (HR) 4.013, [95% confidence interval (95% CI) 1.988-8.101]; P \textless 0.001\ and composite events [HR 2.332 (95% CI 1.378-3.945); P \textless 0.01], independently of age, sex, serum [Na(+)] and albumin. In multiple regression models, dialysate [Na(+)], serum albumin and congestive heart failure were significantly associated with skin [Na(+)] in HD patients (R(2) (adj) = 0.62). CONCLUSIONS: Higher skin [Na(+)] was associated with worse clinical outcomes in dialysis patients and may represent a direct therapeutic target.
Fichier principal
Vignette du fichier
sfac021.pdf (933.67 Ko) Télécharger le fichier
Origine : Publication financée par une institution

Dates et versions

inserm-03830399 , version 1 (26-10-2022)

Identifiants

Citer

F. R. Salerno, A. Akbari, S. Lemoine, G. Filler, T. J. Scholl, et al.. Outcomes and predictors of skin sodium concentration in dialysis patients. Clinical Kidney Journal, 2022, 15 (6), pp.1129-1136. ⟨10.1093/ckj/sfac021⟩. ⟨inserm-03830399⟩
11 Consultations
20 Téléchargements

Altmetric

Partager

Gmail Facebook X LinkedIn More