Hammon Matthias, Grossmann Susan, Linz Peter, Seuss Hannes, Hammon Rebecca, Rosenhauer Daniela, Janka Rolf, Cavallaro Alexander, Luft Friedrich C, Titze Jens, Uder Michael, Dahlmann Anke
Department of Radiology, University Hospital Erlangen, Friedrich Alexander Universität (FAU) Erlangen-Nürnberg, Maximiliansplatz 1, 91054 Erlangen, Germany.
Department of Radiology, University Hospital Erlangen, Friedrich Alexander Universität (FAU) Erlangen-Nürnberg, Maximiliansplatz 1, 91054 Erlangen, Germany.
Acad Radiol. 2017 Sep;24(9):1086-1093. doi: 10.1016/j.acra.2017.03.012. Epub 2017 May 8.
Sodium and proton magnetic resonance imaging (Na/H-MRI) have shown that muscle and skin can store Na without water. In chronic renal failure and in heart failure, Na mobilization occurs, but is variable depending on age, dialysis vintage, and other features. Na storage depots have not been studied in patients with acute kidney injury (AKI).
We studied 7 patients with AKI (mean age: 51.7 years; range: 25-84) and 14 age-matched and gender-matched healthy controls. All underwent Na/H-MRI at the calf. Patients were studied before and after acute hemodialysis therapy within 5-6 days. The Na-MRI produced grayscale images containing Na phantoms, which served to quantify Na contents. A fat-suppressed inversion recovery sequence was used to quantify HO content.
Plasma Na levels did not change. Mean Na contents in muscle and skin did not significantly change following four to five cycles of hemodialysis treatment (before therapy: 32.7 ± 6.9 and 44.2 ± 13.5 mmol/L, respectively; after dialysis: 31.7 ± 10.2 and 42.8 ± 11.8 mmol/L, respectively; P > .05). Water content measurements did not differ significantly before and after hemodialysis in muscle and skin (P > .05). Na contents in calf muscle and skin of patients before hemodialysis were significantly higher than in healthy subjects (16.6 ± 2.1 and 17.9 ± 3.2) and remained significantly elevated after hemodialysis.
Na in muscle and skin accumulates in patients with AKI and, in contrast to patients receiving chronic hemodialysis and those with acute heart failure, is not mobilized with hemodialysis within 5-6 days.
钠和质子磁共振成像（Na/H-MRI）显示肌肉和皮肤能够无水储存钠。在慢性肾衰竭和心力衰竭患者中，会发生钠动员，但因年龄、透析年限及其他特征而异。急性肾损伤（AKI）患者的钠储存库尚未得到研究。
我们研究了7例AKI患者（平均年龄：51.7岁；范围：25 - 84岁）和14例年龄及性别匹配的健康对照者。所有人均在小腿进行了Na/H-MRI检查。患者在5 - 6天内接受急性血液透析治疗前后进行了研究。Na-MRI生成了包含钠体模的灰度图像，用于量化钠含量。使用脂肪抑制反转恢复序列来量化水含量。
血浆钠水平未发生变化。经过四到五个血液透析治疗周期后，肌肉和皮肤中的平均钠含量没有显著变化（治疗前：分别为32.7±6.9和44.2±13.5 mmol/L；透析后：分别为31.7±10.2和42.8±11.8 mmol/L；P＞0.05）。血液透析前后肌肉和皮肤中的水含量测量值无显著差异（P＞0.05）。血液透析前患者小腿肌肉和皮肤中的钠含量显著高于健康受试者（分别为16.6±2.1和17.9±3.2），血液透析后仍显著升高。
AKI患者的肌肉和皮肤中会蓄积钠，与接受慢性血液透析的患者和急性心力衰竭患者不同，在5 - 6天内血液透析并不能动员这些钠。
