Evaluation of volume overload by bioelectrical impedance analysis, NT-proBNP and inferior vena cava diameter in patients with stage 3&4 and 5 chronic kidney disease.
BACKGROUND
Determination of fluid overload is important in chronic kidney disease. Early diagnosis and treatment of volume overload may decrease morbidity and mortality. We aimed to determine body composition by using bioelectrical impedance analysis, and studying other clinical characteristics, inferior vena cava diameter, and N-terminal pro-B natriuretic peptide associated with hydration status in chronic kidney disease Stages 3&4 and 5 in patients not undergoing dialysis.


METHODS
We examined 62 patients with Stages 3&4 and 68 patients with Stage 5 chronic kidney disease. Plasma NT-proBNP was measured and analyzed after log transformation. Inferior vena cave diameter was measured with echocardiography and indexed for body surface area. Hydration status was assessed using multi-frequency bioelectrical impedance analysis. Overhydration was defined as overhydration/extracellular water >0.15.


RESULTS
Overhydration was more frequent in Stage 5 than in Stages 3&4 patients. Systolic and diastolic blood pressure, inferior vena cava index, and log NT-proBNP were higher in overhydrated compared to non-overhydrated patients. A significant positive correlation existed between overhydration/extracellular water and log NT-proBNP, systolic and diastolic blood pressures, and inferior vena cava index. In multiple linear regression analysis, the variables associated with hydration status were male sex, extracellular water/total body water, and extracellular water/intracellular water (greater overhydration), while serum albumin levels had a negative association with overhydration.


CONCLUSIONS
Overhydration is more prevalent in Stage 5 chronic kidney disease patients than in Stages 3&4 patients. Bioelectrical impedance analysis, inferior vena cava diameter, and NT-proBNP analysis in chronic kidney disease are useful methods to determine the volume overload.
Department of Nephrology, Faculty of Medicine, Dicle University , Diyarbakir , Turkey and.
Zülfükar
Z
Yilmaz
Yaşar
Y
Yildirim
Ferhat
F
Oto
Fatma Yilmaz
FY
Aydin
Emre
E
Aydin
Ali Kemal
AK
Kadiroglu
Mehmet Emin
ME
Yilmaz
D000328:Adult; D000368:Aged; D001794:Blood Pressure; D001823:Body Composition; D004452:Echocardiography; D017097:Electric Impedance; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D010446:Peptide Fragments / Q000097:blood*; D051436:Renal Insufficiency, Chronic / Q000150:complications* / Q000503:physiopathology; D012709:Serum Albumin / Q000378:metabolism; D014682:Vena Cava, Inferior / Q000033:anatomy & histology / Q000000981:diagnostic imaging*; D014883:Water-Electrolyte Imbalance / Q000175:diagnosis*
D010446:Peptide Fragments; D012709:Serum Albumin; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain