title: Echocardiographic impact of hydration status in dialysis patients.
abstract: BACKGROUND
  Cardiovascular disease is the main cause of death in Chronic Kidney Disease patients. Left ventricular hypertrophy is the most common manifestation and it is linked to arterial hypertension and overhydration. The goal of this paper is to stratify dialyzed patients according to hydration status and to make an evaluation about the possible echocardiography alterations of the different groups.
  
  
  METHODS
  A transversal study was carried out with 117 patients: 65 were on hemodialysis and 52 on peritoneal dialysis. We performed the following tests: multifrequency bioimpedance with the BCM-Body Composition Freesenius’ Monitor system, transthoracic echocardiography, and blood tests. If ECW/TBW (extracellular water vs total body water) normalization ratio for age and gender was > 2.5% SD, the patient was considered overhydrated.
  
  
  RESULTS
  HD patients are significantly overhydrated before HD (67.1%) compared to DP patients (46.1%), and almost half of the overhydrated population presents arterial hypertension. However, after an HD session, a better control of the hydration status is reached (26.1%). DP patients frequently present high arterial pressure and/or are under antihypertensive treatment (DP 76.9% vs HD 49.2%). Left ventricular hypertrophy is much more common in HD overhydrated patients, eccentric LVH being more prevalent. Overhydrated patients present significantly high values of LAVI, ILVM, OH/ECW.
  
  
  CONCLUSIONS
  Bioimpedance technique allows for the detection of a large number of overhydrated patients. Echocardiographic alterations in dialyzed patients show a high correlation between the hydration stage by ECW/TBW normalized ratio for age and gender and the LAVI and ILVM.
authors.affiliation: Nefrología, Hospital Clínico Universitario De Valencia, Valencia, Valencia, España. ijuangar@hotmail.com
authors.forename: Isabel
authors.initials: I
authors.lastname: Juan-García
authors.forename: María J
authors.initials: MJ
authors.lastname: Puchades
authors.forename: Rafael
authors.initials: R
authors.lastname: Sanjuán
authors.forename: Isidro
authors.initials: I
authors.lastname: Torregrosa
authors.forename: Miguel Á
authors.initials: MÁ
authors.lastname: Solís
authors.forename: Miguel
authors.initials: M
authors.lastname: González
authors.forename: Marisa
authors.initials: M
authors.lastname: Blasco
authors.forename: Antonio
authors.initials: A
authors.lastname: Martínez
authors.forename: Alfonso
authors.initials: A
authors.lastname: Miguel
mesh_terms: D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D017379:Hypertrophy, Left Ventricular / Q000000981:diagnostic imaging* / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D010530:Peritoneal Dialysis; D006435:Renal Dialysis; D014463:Ultrasonography; D014883:Water-Electrolyte Imbalance / Q000150:complications*