Measuring kidney sodium content in patients with heart failure and kidney disease
Evaluation of Kidney Medullary Sodium Content Using 23Na MRI to Understand and Predict Diuretic Resistance
This study is testing if measuring sodium levels in the kidneys can help doctors understand how well diuretics work for people with heart failure and kidney disease.
Quick facts
| Phase | Not applicable |
|---|---|
| Study type | Interventional |
| Enrollment | 50 (estimated) |
| Ages | 18 Years and up |
| Sex | All |
| Sponsor | London Health Sciences Centre Research Institute OR Lawson Research Institute of St. Joseph's Academic / other |
| Locations | 1 site (London, Ontario) |
| Trial ID | NCT04170855 on ClinicalTrials.gov |
What this trial studies
This interventional pilot study aims to explore the relationship between kidney sodium content and diuretic response in patients suffering from cardio-renal syndrome. Participants will undergo a combined MRI scan to measure sodium levels in their kidneys, alongside various assessments including questionnaires, echocardiograms, and blood tests. The study seeks to identify whether measuring kidney sodium can predict resistance to diuretic therapy, which is a common challenge in managing heart failure. If successful, this approach could lead to more personalized and effective diuretic dosing for patients.
Who should consider this trial
Good fit: Ideal candidates include adults aged 18 and older with a clinical diagnosis of heart failure who are currently receiving loop diuretics.
Not a fit: Patients with direct contraindications to MRI scanning or those with liver disease, certain kidney conditions, or who are pregnant may not benefit from this study.
Why it matters
Potential benefit: If successful, this study could enable more accurate diuretic dosing, reducing the risk of treatment failure and side effects in patients with heart failure and kidney disease.
How similar studies have performed: While the approach of using MRI to measure kidney sodium content is innovative, similar studies have not been widely reported, indicating this may be a novel exploration.
Eligibility criteria
Show full inclusion / exclusion 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)
Where this trial is running
London, Ontario
- Heart Failure Clinic | St. Joseph's Health Care London — London, Ontario, Canada (Recruiting)
Study contacts
- Principal investigator: Christopher W McIntyre, MD — Western University
- Study coordinator: Christopher W McIntyre, MD
- Email: cmcint48@uwo.ca
- Phone: 519.685.8500
How to participate
- Review the eligibility criteria above with your treating physician.
- Visit the official trial page on ClinicalTrials.gov for the most current contact information and recruitment status.
- Contact the listed study coordinator or principal investigator to request pre-screening. Pre-screening is free and never obligates you to enroll.