title: Dialysis patients' fluid overload, antihypertensive medications, and obesity.
abstract: Overhydration (OH) is both a major etiology of hypertension in hemodialysis patients and a serious risk factor for mortality. We investigated the association of multiple variables and OH. This is a cross-sectional study of prevalent hemodialysis patients examining the predialysis hydrational status with a portable bioimpedance apparatus to measure the degree of hydration. We completed our study in 79 patients. Patients were overhydrated by 2.6 ± 2.4 L. The mean medication count was 2.4 ± 1.5, and 50.7% had diuretics. We found a significant correlation between OH and systolic blood pressure (r = 0.39; p = 0.0006), each liter of OH generating 3.6 mm Hg. We also found a positive correlation between the use of diuretics and OH (p = 0.003, two-tailed Student's t test) but no correlation between OH and body weight (r < 0.0001; p = 0.99), body mass index (r = -0.17), age (r = 0.089), and vintage (r = 0.05). For every 10% increase in body fat, OH decreased by 1.2 L; residual urine output gave no protection from OH (r = 0.077) and did not correlate with blood pressure (r = 0.01). Overhydration is strongly associated with the use of antihypertensive medications and the use of diuretics in this dialysis population. Obesity seems to afford some protection from OH.
authors: Fresenius Dialysis Center, Semmelweis University, Budapest, Hungary. mtapolyai@aol.com
authors: Mihály
authors: M
authors: Tapolyai
authors: Mária
authors: M
authors: Faludi
authors: Virág
authors: V
authors: Réti
authors: Zsolt
authors: Z
authors: Lengvárszky
authors: Tibor
authors: T
authors: Szarvas
authors: Klára
authors: K
authors: Berta
mesh_terms: D000959:Antihypertensive Agents / Q000627:therapeutic use*; D001826:Body Fluids / Q000187:drug effects / Q000502:physiology*; D003430:Cross-Sectional Studies; D017097:Electric Impedance; D005260:Female; D006801:Humans; D006973:Hypertension / Q000188:drug therapy; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000503:physiopathology*; D006435:Renal Dialysis; D012307:Risk Factors; D014883:Water-Electrolyte Imbalance / Q000503:physiopathology
chemical_list: D000959:Antihypertensive Agents