As kidneys fail, they lose their ability to balance salt and fluid in the body. This can cause salt and fluid overload leading to high blood pressure, leg swelling, breathing difficulties and inevitably heart damage. This is the commonest problem our predialysis and dialysis patients face, often leading to strict restriction of salt and water intake, reducing quality of life significantly. This restriction is mostly advised without specific information on individuals’ salt stores. The relationship of salt and water excess and it is handling by the body when the kidneys fail is not understood. Research has been limited by the lack of methods to measure salt stores. Recent studies suggest that salt stores might be hidden in body spaces away form water stores, meaning that common methods for removing them may be inefficient. Importantly it has been suggested that some patients may not be as salt overloaded as doctors think.
Working with the Welcome Trust Imaging facility, the University of Manchester and CMFT, we have an opportunity to use a specialised sodium coil and MR imaging to picture salt storage in the body. We wish to study how salt and water is stored and handled by the body, in dialysis patients which will involve 3 MRI scans; before and after a dialysis session and prior to the next dialysis. By learning more about salt’s behaviour we may understand better how to remove more accurately excess water and salt on dialysis. We believe this study will prove that this technique can be used to study salt in patients with hypertension and heart failure in the general population. This use of MRI technique will be the first in kidney patients in the UK and will help establish Manchester as a leader in this research area.