Kidney Sodium Content in Cardiorenal Patients

• Status: Recruiting
• Trial end date: 2021-11-01
• Target enrollment: 0
• Participant gender: All

Summary

Diuretic therapy is the cornerstone of the management of fluid overload in heart failure. Resistance to diuretic therapy is the most common reason for treatment failure in patients affected by the combination of heart failure and kidney disease. Currently, there is no way of predicting whether heart failure patients will develop resistance to diuretic therapy and what dose of diuretic is necessary to overcome diuretic resistance. Answering these questions would allow doctors to be able to prescribe an accurate dose of diuretic therapy to prevent diuretic resistance and potential side effects of an excessive diuretic dose.

With magnetic resonance imaging, it is possible to measure the kidney sodium (salt) content and observe the diuretic response in patients with heart failure and kidney disease. The investigators speculate that measuring kidney sodium content will allow to predict diuretic response in these patients.

The aim of this study is to compare the kidney sodium content in patients with chronic cardiorenal syndrome with and without diuretic resistance. Secondly, in a sample of patients with diagnosed diuretic resistance,the aim will be to observe the changes in kidney sodium content induced by an additional dose of diuretic therapy and to observe whether these changes are associated with a response to diuretic therapy.

• Phase: N/A
• Accepts Healthy Volunteers?: No

Details

• Lead Sponsor: Lawson Health Research Institute
• Treatments: Diuretics; Furosemide

Criteria

Inclusion Criteria for Visit 1

• Clinico-pathological diagnosis of heart failure

• Age ≥ 18 years

• Estimated GFR ≥ 15 mL/min/1.73m2

• Receiving loop diuretics for at least a week at ≥ 40 mg/day (furosemide) or 2 mg/day (bumetanide), either orally or intravenously

• Willing and able to provide consent

Inclusion Criteria for Visit 2 · Patients from visit 1 with diuretic resistance

Exclusion Criteria for Visit 1 Direct contraindications to MR scanning (implanted materials etc.)

• Additional diuretic types other than spironolactone/epleronone/metolazone/finerenone

• Liver disease with hepato-renal syndrome

• Pregnant, breastfeeding or intending pregnancy

• Kidney malformation leading to chronic kidney disease (for example polycystic kidney)

• Unable to provide consent

Exclusion criteria for Visit 2

· Hypokalemia (serum potassium <3.5 mmol/l)