Shoumariyeh Tarik, Logar Florian, Helk Oliver, Hofer Johannes, Schmetterer Klaus G, Mersi Brigitte, Gruber Saskia, Säemann Marcus D, Kaltenecker Christopher C, Kovarik Johannes J
Department of Internal Medicine III, Division of Nephrology and Dialysis, Medical University of Vienna, General Hospital of Vienna, Vienna, Austria.
Department of Ophthalmology, Academic Teaching Hospital of St. John of God, Vienna, Austria.
Sci Rep. 2025 Jul 2;15(1):22518. doi: 10.1038/s41598-025-05855-8.
Excretion of sodium and water through the skin as sweat represents a regulatory mechanism of electrolyte- and fluid balance. Since patients with chronic kidney disease (CKD) exhibit increased skin sodium content, we investigated the feasibility of sweat testing as a novel experimental tool to provide a more complete assessment of fluid- and sodium status. In this cross-sectional feasibility study, we applied pilocarpine iontophoresis to induce sweat testing in 58 patients across various stages of CKD including kidney transplant recipients and a healthy control cohort (n = 6) to investigate possible effects of CKD and transplantation status on sweat weight and sodium concentration. Due to non-linear relationships, we modeled our data using polynomial regression. Decline of kidney function showed a significant association with lower sweat weight: adj R = 0.2278, F(2, 61) = 10.29, p = 0.0001. Sweat sodium concentrations were increased in moderate CKD, however, this effect was lost in end-stage kidney disease with and without requirement of hemodialysis: adj R = 0.3701, F(4, 59) = 10.26, p = 2.261e-06. Diagnostic sweat analysis represents an innovative, non-invasive option for a more thorough investigation of sodium- and fluid homeostasis in CKD. Lower sweat weight and higher sweat sodium concentrations represent a unique feature of CKD patients with potential therapeutic implications.Trial registration: This study is registered at ClinTrials.gov with the study number NCT06354842.
通过皮肤以汗液形式排泄钠和水是电解质和液体平衡的一种调节机制。由于慢性肾脏病（CKD）患者的皮肤钠含量增加，我们研究了汗液检测作为一种新型实验工具的可行性，以更全面地评估液体和钠的状态。在这项横断面可行性研究中，我们应用毛果芸香碱离子导入法对58例不同阶段的CKD患者（包括肾移植受者）和一个健康对照队列（n = 6）进行汗液检测，以研究CKD和移植状态对汗液重量和钠浓度的可能影响。由于存在非线性关系，我们使用多项式回归对数据进行建模。肾功能下降与较低的汗液重量显著相关：调整R = 0.2278，F(2, 61) = 10.29，p = 0.0001。中度CKD患者的汗液钠浓度升高，然而，在终末期肾病患者中，无论是否需要血液透析，这种效应都消失了：调整R = 0.3701，F(4, 59) = 10.26，p = 2.261e - 06。诊断性汗液分析是一种创新的、非侵入性的方法，可用于更深入地研究CKD患者的钠和液体稳态。较低的汗液重量和较高的汗液钠浓度是CKD患者的独特特征，可能具有治疗意义。试验注册：本研究已在ClinicalTrials.gov注册，研究编号为NCT06354842。
