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Fluid overload in hemodialysis patients: a cross-sectional study to determine its association with cardiac biomarkers and nutritional status

BACKGROUND: Chronic fluid overload is associated with higher mortality in dialysis patients; however, the link with cardiovascular morbidity has not formally been established and may be influenced by subclinical inflammation. We hypothesized that a relationship exists between fluid overload and [i]...

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Autores principales: Antlanger, Marlies, Hecking, Manfred, Haidinger, Michael, Werzowa, Johannes, Kovarik, Johannes J, Paul, Gernot, Eigner, Manfred, Bonderman, Diana, Hörl, Walter H, Säemann, Marcus D
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2013
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4219439/
https://www.ncbi.nlm.nih.gov/pubmed/24295522
http://dx.doi.org/10.1186/1471-2369-14-266
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author Antlanger, Marlies
Hecking, Manfred
Haidinger, Michael
Werzowa, Johannes
Kovarik, Johannes J
Paul, Gernot
Eigner, Manfred
Bonderman, Diana
Hörl, Walter H
Säemann, Marcus D
author_facet Antlanger, Marlies
Hecking, Manfred
Haidinger, Michael
Werzowa, Johannes
Kovarik, Johannes J
Paul, Gernot
Eigner, Manfred
Bonderman, Diana
Hörl, Walter H
Säemann, Marcus D
author_sort Antlanger, Marlies
collection PubMed
description BACKGROUND: Chronic fluid overload is associated with higher mortality in dialysis patients; however, the link with cardiovascular morbidity has not formally been established and may be influenced by subclinical inflammation. We hypothesized that a relationship exists between fluid overload and [i] cardiovascular laboratory parameter as well as between fluid overload and [ii] inflammatory laboratory parameters. In addition, we aimed to confirm whether volume status correlates with nutritional status. METHODS: We recorded baseline characteristics of 244 hemodialysis patients at three hemodialysis facilities in Vienna (Austria) and determined associations with volume measurements using the body composition monitor (Fresenius/Germany). In one facility comprising 126 patients, we further analyzed cardiovascular, inflammatory and nutritional parameters. RESULTS: We detected predialysis fluid overload (FO) in 39% of all patients (n = 95) with FO defined as ≥15% of extracellular water (ECW). In this subgroup, the absolute FO was 4.4 +/-1.5 L or 22.9 ± 4.8% of ECW. A sub-analysis of patients from one center showed that FO was negatively associated with body mass index (r = -0.371; p = <0.001), while serum albumin was significantly lower in fluid overloaded patients (p = 0.001). FO was positively associated with D-Dimer (r = 0.316; p = 0.001), troponin T (r = 0.325; p < 0.001), and N-terminal pro-B-type natriuretic peptide (r = 0.436; p < 0.001), but not with investigated inflammatory parameters. CONCLUSIONS: Fluid overload in HD patients was found to be lower in patients with high body mass index, indicating that dry weight was inadequately prescribed and/or difficult to achieve in overweight patients. The association with parameters of cardiovascular compromise and/or damage suggests that fluid overload is a biomarker for cardiovascular risk. Future studies should determine if this applies to patients prior to end-stage renal disease.
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spelling pubmed-42194392014-11-05 Fluid overload in hemodialysis patients: a cross-sectional study to determine its association with cardiac biomarkers and nutritional status Antlanger, Marlies Hecking, Manfred Haidinger, Michael Werzowa, Johannes Kovarik, Johannes J Paul, Gernot Eigner, Manfred Bonderman, Diana Hörl, Walter H Säemann, Marcus D BMC Nephrol Research Article BACKGROUND: Chronic fluid overload is associated with higher mortality in dialysis patients; however, the link with cardiovascular morbidity has not formally been established and may be influenced by subclinical inflammation. We hypothesized that a relationship exists between fluid overload and [i] cardiovascular laboratory parameter as well as between fluid overload and [ii] inflammatory laboratory parameters. In addition, we aimed to confirm whether volume status correlates with nutritional status. METHODS: We recorded baseline characteristics of 244 hemodialysis patients at three hemodialysis facilities in Vienna (Austria) and determined associations with volume measurements using the body composition monitor (Fresenius/Germany). In one facility comprising 126 patients, we further analyzed cardiovascular, inflammatory and nutritional parameters. RESULTS: We detected predialysis fluid overload (FO) in 39% of all patients (n = 95) with FO defined as ≥15% of extracellular water (ECW). In this subgroup, the absolute FO was 4.4 +/-1.5 L or 22.9 ± 4.8% of ECW. A sub-analysis of patients from one center showed that FO was negatively associated with body mass index (r = -0.371; p = <0.001), while serum albumin was significantly lower in fluid overloaded patients (p = 0.001). FO was positively associated with D-Dimer (r = 0.316; p = 0.001), troponin T (r = 0.325; p < 0.001), and N-terminal pro-B-type natriuretic peptide (r = 0.436; p < 0.001), but not with investigated inflammatory parameters. CONCLUSIONS: Fluid overload in HD patients was found to be lower in patients with high body mass index, indicating that dry weight was inadequately prescribed and/or difficult to achieve in overweight patients. The association with parameters of cardiovascular compromise and/or damage suggests that fluid overload is a biomarker for cardiovascular risk. Future studies should determine if this applies to patients prior to end-stage renal disease. BioMed Central 2013-12-02 /pmc/articles/PMC4219439/ /pubmed/24295522 http://dx.doi.org/10.1186/1471-2369-14-266 Text en Copyright © 2013 Antlanger et al.; licensee BioMed Central Ltd. http://creativecommons.org/licenses/by/2.0 This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Research Article
Antlanger, Marlies
Hecking, Manfred
Haidinger, Michael
Werzowa, Johannes
Kovarik, Johannes J
Paul, Gernot
Eigner, Manfred
Bonderman, Diana
Hörl, Walter H
Säemann, Marcus D
Fluid overload in hemodialysis patients: a cross-sectional study to determine its association with cardiac biomarkers and nutritional status
title Fluid overload in hemodialysis patients: a cross-sectional study to determine its association with cardiac biomarkers and nutritional status
title_full Fluid overload in hemodialysis patients: a cross-sectional study to determine its association with cardiac biomarkers and nutritional status
title_fullStr Fluid overload in hemodialysis patients: a cross-sectional study to determine its association with cardiac biomarkers and nutritional status
title_full_unstemmed Fluid overload in hemodialysis patients: a cross-sectional study to determine its association with cardiac biomarkers and nutritional status
title_short Fluid overload in hemodialysis patients: a cross-sectional study to determine its association with cardiac biomarkers and nutritional status
title_sort fluid overload in hemodialysis patients: a cross-sectional study to determine its association with cardiac biomarkers and nutritional status
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4219439/
https://www.ncbi.nlm.nih.gov/pubmed/24295522
http://dx.doi.org/10.1186/1471-2369-14-266
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