MRI and volume homeostasis in hemodialysis patients

End-stage renal insufficiency requires renal replacement therapy, either a form
of dialysis or kidney transplantation. The major difficulty concerning dialysis
is maintaining volume homeostasis. Assessment of volume status is mostly based
on clinical examination of the patient and the weight at the end of the
previous dialysis treatment. Wrong assessment induces either hypervolemia or
hypovolemia, both negatively impacting the clinical condition of the patient
and residual renal function. More objective measurements such as biochemical
markers, inferior vena cava ultrasound and bioimpedance analysis all possess
substantial limitations. We hypothesize that magnetic resonance imaging could
be an accurate diagnostic tool for assessment of tissue water content and total
body volume status.

To investigate the application of magnetic resonance imaging in detecting
changes in tissue water content in patients undergoing hemodialysis.

Quasi-experimental observational study

The burden for the individual participant consists of undergoing MRI scanning,
which could be considered time-consuming and claustrophobic. One MRI session
might last up to half an hour to obtain images of brain, liver and calf muscle.
Patient claustrophobia is a relative contra-indication for undergoing a MRI
scan. In addition, inferior vena cava ultrasound measurement, weight
measurement and bioimpedance analysis will be a substantial part of
participation. Since all measurements will be performed before and after one
single hemodialysis session, there is no need for additional hospital visits.
Potential risks linked to participation are minimal. Each patient will be
screened for ferromagnetic implants, pregnancy and claustrophobia through usage
of a standardised questionnaire.