Volume-Independent Sodium Toxicity in Peritoneal Dialysis: New Insights from Bench to Bed

Sodium overload is common in end-stage kidney disease (ESKD) and is associated with increased cardiovascular mortality that is traditionally considered a result of extracellular volume expansion. Recently, sodium storage was detected by Na23 magnetic resonance imaging in the interstitial tissue of the skin and other tissues. This amount of sodium is osmotically active, regulated by immune cells and the lymphatic system, escapes renal control, and, more importantly, is associated with salt-sensitive hypertension. In chronic kidney disease, the interstitial sodium storage increases as the glomerular filtration rate declines and is related to cardiovascular damage, regardless of the fluid overload. This sodium accumulation in the interstitial tissues becomes more significant in ESKD, especially in older and African American patients. The possible negative effects of interstitial sodium are still under study, though a higher sodium intake might induce abnormal structural and functional changes in the peritoneal wall. Interestingly, sodium stored in the interstial tissue is not unmodifiable, since it is removable by dialysis. Nevertheless, the sodium removal by peritoneal dialysis (PD) remains challenging, and new PD solutions are desirable. In this narrative review, we carried out an update on the pathophysiological mechanisms of volume-independent sodium toxicity and possible future strategies to improve sodium removal by PD.

Sodium Toxicity in the Nutritional Epidemiology and Nutritional Immunology of COVID-19

Dietary factors in the etiology of COVID-19 are understudied. High dietary sodium intake leading to sodium toxicity is associated with comorbid conditions of COVID-19 such as hypertension, kidney disease, stroke, pneumonia, obesity, diabetes, hepatic disease, cardiac arrhythmias, thrombosis, migraine, tinnitus, Bell’s palsy, multiple sclerosis, systemic sclerosis, and polycystic ovary syndrome. This article synthesizes evidence from epidemiology, pathophysiology, immunology, and virology literature linking sodium toxicological mechanisms to COVID-19 and SARS-CoV-2 infection. Sodium toxicity is a modifiable disease determinant that impairs the mucociliary clearance of virion aggregates in nasal sinuses of the mucosal immune system, which may lead to SARS-CoV-2 infection and viral sepsis. In addition, sodium toxicity causes pulmonary edema associated with severe acute respiratory syndrome, as well as inflammatory immune responses and other symptoms of COVID-19 such as fever and nasal sinus congestion. Consequently, sodium toxicity potentially mediates the association of COVID-19 pathophysiology with SARS-CoV-2 infection. Sodium dietary intake also increases in the winter, when sodium losses through sweating are reduced, correlating with influenza-like illness outbreaks. Increased SARS-CoV-2 infections in lower socioeconomic classes and among people in government institutions are linked to the consumption of foods highly processed with sodium. Interventions to reduce COVID-19 morbidity and mortality through reduced-sodium diets should be explored further.

Application of Exogenous Protectants Mitigates Salt-Induced Na+ Toxicity and Sustains Cotton (Gossypium hirsutum L.) Seedling Growth: Comparison of Glycine Betaine and Salicylic Acid

Soil salinization adversely affects agricultural productivity. Mitigating the adverse effects of salinity represents a current major challenge for agricultural researchers worldwide. The effects of exogenously applied glycine betaine (GB) and salicylic acid (SA) on mitigating sodium toxicity and improving the growth of cotton seedlings subjected to salt stress remain unclear. The treatments in a phytotron included a control (CK, exogenously untreated, non-saline), two NaCl conditions (0 and 150 mM), four exogenous GB concentrations (0, 2.5, 5.0, and 7.5 mM), and four exogenous SA concentrations (0, 1.0, 1.5, and 2.0 mM). The shoot and roots exposed to 150 mM NaCl without supplementation had significantly higher Na+ and reduced K+, Ca2+, and Mg2+ contents, along with lowered biomass, compared with those of CK. Under NaCl stress, exogenous GB and SA at all concentrations substantially inversed these trends by improving ion uptake regulation and biomass accumulation compared with NaCl stress alone. Supplementation with 5.0 mM GB and with 1.0 mM SA under NaCl stress were the most effective conditions for mitigating Na+ toxicity and enhancing biomass accumulation. NaCl stress had a negative effect on plant growth parameters, including plant height, leaf area, leaf water potential, and total nitrogen (N) in the shoot and roots, which were improved by supplementation with 5.0 mM GB or 1.0 mM SA. Supplementation with 5.0 mM exogenous GB was more effective in controlling the percentage loss of conductivity (PLC) under NaCl stress.

Physiological Basis of Salt Stress Tolerance in a Landrace and a Commercial Variety of Sweet Pepper (Capsicum annuum L.)

Salt stress is one of the most impactful abiotic stresses that plants must cope with. Plants’ ability to tolerate salt stress relies on multiple mechanisms, which are associated with biomass and yield reductions. Sweet pepper is a salt-sensitive crop that in Mediterranean regions can be exposed to salt build-up in the root zone due to irrigation. Understanding the physiological mechanisms that plants activate to adapt to soil salinization is essential to develop breeding programs and agricultural practices that counteract this phenomenon and ultimately minimize yield reductions. With this aim, the physiological and productive performances of Quadrato D’Asti, a common commercial sweet pepper cultivar in Italy, and Cazzone Giallo, a landrace of the Campania region (Italy), were compared under different salt stress treatments. Quadrato D’Asti had higher tolerance to salt stress when compared to Cazzone Giallo in terms of yield, which was associated with higher leaf biomass vs. fruit ratio in the former. Ion accumulation and profiling between the two genoptypes revealed that Quadrato D’Asti was more efficient at excluding chloride from green tissues, allowing the maintenance of photosystem functionality under stress. In contrast, Cazzone Giallo seemed to compartmentalize most sodium in the stem. While sodium accumulation in the stems has been shown to protect shoots from sodium toxicity, in pepper and/or in the specific experimental conditions imposed, this strategy was less efficient than chloride exclusion for salt stress tolerance.

Assessment of water quality of Garmat Ali river for irrigation purposes

This study investigates the suitability of Garmat Ali river (Iraq) for irrigation uses. Two stations were chosen: station A; far from any polluted water discharge point, and station C; near to a very contaminated water discharge point). Water samples were picked up and tested for pH, electrical conductivity, total dissolved solids, sodium, potassium, calcium, magnesium, bicarbonate, sulfate, chlorine, and nitrate. Three samples were collected in January and March 2019 from each site, to reflect the wet season in Iraq. Besides the classification of water quality parameters of Garmat Ali river for watering, other parameters were also calculated, such as sodium adsorption ratio, soluble sodium percentage, exchangeable sodium percentage, magnesium hazard, kelly ratio, permeability index, and potential salinity. According to the Food and Agriculture Organization (FAO) guidelines, the overall results showed that the salinity and chlorine were within the range that causing severe problem to plants. In addition, sodium toxicity and hazard were classified the river water as unsuitable for irrigation. Potential salinity was under the class of unsuitable for irrigation. Bicarbonate hazard was under the category “slight to moderate”. However, the remaining parameters were within the accepted range. Most of the contaminants were higher in the polluted station.

WATER AND SALT STRESSES ON GERMINATION OF COWPEA ( Vigna unguiculata cv. BRS Tumucumaque) SEEDS

ABSTRACT The objective of this work was to evaluate seeds of cowpea, cultivar BRS Tumucumaque, subjected to different water stresses induced by polyethylene glycol (PEG-6000) and mannitol and different salt stresses induced by NaCl and CaCl2 solutions. The water and salt stresses was evaluated in laboratory using completely randomized experimental designs in 2x6 factorial arrangements, with six osmotic potentials (0.0, -0.2, -0.4, -0.6, -0.8 and -1.0 MPa) and two stress inducers for each experiment, with four replications of 50 seeds. The percentage of germination, germination speed index, root and shoot lengths and seedling fresh weight were evaluated at the tenth day (end of the evaluation period). The simulated water stress showed effects on the cowpea seed germination and seedling initial growth by decreasing the rates of the variables evaluated, which had greater effect in treatments with PEG-6000. The salt stress induced by NaCl showed greater effect on the variables evaluated than that induced by CaCl2, due to the sodium toxicity in the salt chemical composition.