About this trial
The corticomedullary gradient is largely responsible for developing the gradients that are needed to concentrate urine (more solutes and less water). The ability of the kidneys to produce concentrated urine is a major determinant of the ability to survive the warm weather. When temperatures are high, we lose water through sweat, and so the kidneys retain water to maintain fluidity in the blood. The maintenance of a sodium (salt) gradient is required for urine concentration because increased medullary sodium concentration increases the reabsorption of water into the kidney, to be redistributed in the blood. The purpose of this study is to know if the corticomedullary gradient is altered in patients across a wide spectrum of kidney disease using sodium Magnetic Resonance Imaging (MRI), a machine that takes pictures and measures the salt content in the kidneys. 23Na kidney MRI, will provide functional MR of the kidney as a non-invasive tool to describe medullary function to improve management of chronic and kidney disease.
Eligibility criteria
Qualifiers
Age ≥ 18 years
For healthy controls: lack of kidney disease, heart failure, liver cirrhosis and peripheral edema
For CKD stage 1-5: Estimated GFR < 90 mL/min/1.73m²
For patients on maintenance hemodialysis or peritoneal dialysis: more than 3 months duration of therapy
Disqualifiers
Pregnant, breastfeeding or intending pregnancy
Contraindication to MRI
Inability to tolerate MRI due to patient size and/or known history of claustrophobia.
Mechanically implanted, electrically, or magnetically activated device or any metal in their body which cannot be removed, including but not limited to pacemakers, neurostimulators, biostimulators, implanted insulin pumps, aneurysm clips, bioprosthesis, artificial limb, metallic fragment or foreign body, tattoos, shunt, surgical staples (including clips or metallic sutures and/or ear implants.)
Trial design
Treatments tested in this trial
- Sodium-23 MRI
Treatment groups
6
Treatment groupsSee each treatment group below.