Kidney Sodium Content in Cardiorenal Patients

NCT04170855Sponsor: London Health Sciences Centre Research Institute OR Lawson Research Institute of St. Joseph'sChristopher McIntyreChristopher McIntyre

Actively Recruiting

View on ClinicalTrials.gov ↗

About This Study

This prospective pilot study evaluates the utility of 23Na MRI in measuring kidney medullary sodium content to predict diuretic resistance in patients with chronic cardio-renal syndrome. Investigators compare baseline kidney sodium concentrations between patients with and without diuretic resistance and assess changes in sodium content following an intravenous dose of furosemide in the resistant cohort. Secondary measures include bioimpedance spectroscopy, NYHA classification, echocardiographic parameters, and 24-hour urine volume. The study aims to determine if 23Na MRI can quantify the intrarenal response to loop diuretics and guide precision dosing to overcome treatment failure.

Who Can Participate?

✓ Inclusion 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
  • •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)