The extracellular fluid-to-intracellular fluid volume ratio is associated with large-artery structure and function in hemodialysis patients.
BACKGROUND
Large-artery derangement is a major risk factor for cardiovascular and all-cause mortality in patients with end-stage renal disease (ESRD). It is not clear how body fluid distribution affects large-artery structure and function in patients with ESRD.


METHODS
One hundred fifty-seven hemodialysis (HD) patients (mean age, 55.9 +/- 15.1 years; 76 men, 81 women) were enrolled. Influence of the extracellular fluid (ECF)-to-intracellular fluid (ICF) ratio derived from bioimpedance spectroscopy on the structure and function of the common carotid artery (CCA) and aorta was analyzed. One hundred forty-four healthy subjects were examined to obtain normal reference values for body fluid compartments. Based on ECF-ICF ratio, 2 groups were identified: ECF-ICF ratio in the 95th percentile or less and ECF-ICF ratio greater than the 95th percentile of age- and sex-stratified normal reference values.


RESULTS
ECF-ICF ratio was significantly related to CCA diameter (r2 = 0.26; P < 0.001), CCA incremental modulus (E(inc); r2 = 0.15; P < 0.001), carotid augmentation index (AGI; r2 = 0.10; P < 0.001), and aortic pulse wave velocity (aPWV; r2 = 0.21; P < 0.001). ECF-ICF ratio remained a significant independent determinant for CCA diameter (model r2 = 0.47; P < 0.001), E(inc) (r2 = 0.29; P < 0.001), aPWV (r2 = 0.51; P < 0.001), and AGI (r2 = 0.40; P < 0.001) when age, sex, mean blood pressure, anthropometrical parameters, HD duration, and status of diabetes mellitus were accounted for. HD patients with an ECF-ICF ratio greater than the 95th percentile had a greater CCA diameter, E(inc), aPWV, and AGI than their counterparts.


CONCLUSIONS
ECF-ICF ratio is associated with large-artery structure and function in HD patients. Patients with ESRD with a high ECF-ICF ratio are characterized by significant large-artery derangement.
Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, ROC.
Yao-Ping
YP
Lin
Wen-Chung
WC
Yu
Tsei-Lieh
TL
Hsu
Philip Yu-An
PY
Ding
Wu-Chang
WC
Yang
Chen-Huan
CH
Chen
D000328:Adult; D000367:Age Factors; D000368:Aged; D001011:Aorta / Q000000981:diagnostic imaging / Q000473:pathology* / Q000503:physiopathology; D001795:Blood Pressure Determination; D001916:Brachial Artery / Q000503:physiopathology; D017536:Carotid Artery, Common / Q000000981:diagnostic imaging / Q000473:pathology* / Q000503:physiopathology; D016022:Case-Control Studies; D017097:Electric Impedance; D045604:Extracellular Fluid; D005260:Female; D006801:Humans; D007424:Intracellular Fluid; D008297:Male; D008875:Middle Aged; D012016:Reference Values; D006435:Renal Dialysis; D012737:Sex Factors; D013223:Statistics as Topic; D014463:Ultrasonography; D014682:Vena Cava, Inferior / Q000000981:diagnostic imaging