Extracellular Fluid Excess Is Significantly Associated With Coronary Artery Calcification in Patients With Chronic Kidney Disease

Park, Seohyun; Jhee, Jong Hyun; Yun, Hae‐Ryong; Kim, Hyoungnae; Jung, Su Young; Kee, Youn Kyung; Yoon, Chang Yun; Park, Sun-Hee; Kim, Hyeon Chang; Han, Seung Hyeok; Kang, Shin Wook; Park, Sungha; Yoo, Tae Hyun

doi:10.1161/jaha.118.008935

Cited by 27 publications

(21 citation statements)

References 53 publications

(49 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The ECW/TBW may be an indicator for predicting therapeutic durability in advanced lung cancer and is a useful indicator for nutritional assessment [ 12 ]. However, an increase in ECW/TBW may reflect locomotive syndrome risk and frailty [ 13 , 14 ], chronic liver diseases [ 15 ], renal disorders [ 16 ], coronary artery calcification [ 17 ], and heart failure [ 18 ]. In fact, the extracellular water (ECW) to intracellular water (ICW) ratio (ECW/ICW) was associated with nutritional status [ 19 ], and it can be increased with age among healthy adults [ 20 ].…”

Section: Introductionmentioning

confidence: 99%

Effects of Water Restriction and Water Replenishment on the Content of Body Water with Bioelectrical Impedance among Young Adults in Baoding, China: A Randomized Controlled Trial (RCT)

Zhang

et al. 2021

Nutrients

View full text Add to dashboard Cite

Insufficient water intake may affect body composition. The purpose of this research was to explore the effects of water restriction and replenishment on body composition and to evaluate the optimum amount of water that improves body composition. A total of 76 young adults aged 18–23 years old (40 males and 36 females) in Baoding, China, were recruited in this randomized controlled trial, with a 100% completion rate. After fasting overnight for 12 h, at 8:00 a.m. of day 2, a baseline test, including anthropometric indices and collection of urine and blood samples, was explored. Participants were then subjected to water restriction for 24 h, and three meals with ≤75% water content were provided. At 8:00 AM of day 3, the same indices were determined as a dehydration test. Then, participants were randomly assigned into four groups: three water replenishment groups (WR groups 1, 2, and 3 given 1000, 500, and 200 mL of purified water, respectively) and one non-replenishment group (NR group, with no water). After 90 min, the same measurements were performed as a rehydration test. Compared with the baseline test, during the dehydration test, the intracellular water to total body water ratio (ICW/TBW) increased; and extracellular water (ECW), ECW/TBW (extracellular water to total body water ratio), and TBW decreased (all p < 0.05). For males, significant differences were found in ECW, ECW/ICW (extracellular water to intracellular water ratio), ICW/TBW, and ECW/TBW (all p < 0.05); for females, significant reductions were found in ICW, ECW, TBW, ECW/ICW, ICW/TBW, and ECW/TBW (all p < 0.05). Furthermore, significant differences were found in ICW, ECW, ICW/TBW, ECW/TBW, ECW/ICW, TBW, and TBW/BW between males and females during the baseline and dehydration test (all p < 0.05). Comparing the dehydration test with the rehydration test, there were significant interactions between time × volume in ICW and TBW (F = 3.002, p = 0.036; F = 2.907, p = 0.040); in males, these were only found in ICW (F = 3.061, p = 0.040); in females, they were found in ICW and TBW (F = 3.002, p = 0.036; F = 2.907, p = 0.040). The ICW levels in WR groups 1 and 2 were all higher than in the NR group (all p < 0.05); the TBW was higher in WR group 1 than in the NR group (p < 0.05). No significant differences were found between WR groups 1 and 2, either in males or in females (all p > 0.05). In the rehydration test, significant differences in body composition were found between males and females among the four groups (all p < 0.05). Water restriction had adverse effects on body composition, and females were more susceptible to water restriction than males. Water replenishment improved the water content of body composition, alleviating the adverse effects of water restriction on ICW and TBW. After water restriction for 36 h, the optimum volume of water to improve body composition among young male adults was 1000 mL, but this was not the case for females.

show abstract

Section: Introductionmentioning

confidence: 99%

Effects of Water Restriction and Water Replenishment on the Content of Body Water with Bioelectrical Impedance among Young Adults in Baoding, China: A Randomized Controlled Trial (RCT)

Zhang

et al. 2021

Nutrients

View full text Add to dashboard Cite

show abstract

“…Furthermore, inflammation-induced hypoalbuminemia and increased vascular permeability enhance extravascular fluid shift, thereby resulting in extravascular fluid volume overload 14 . In fact, the ECW/ TBW ratio, which is substantially the same as the ECW/ICW ratio, has been used as a marker of ECW excess 8,49,50 .…”

Section: Discussionmentioning

confidence: 99%

Impact of extracellular‐to‐intracellular fluid volume ratio on albuminuria in patients with type 2 diabetes: A cross‐sectional and longitudinal cohort study

Nakajima

Hashimoto

Kaji

et al. 2020

J of Diabetes Invest

View full text Add to dashboard Cite

Aims/Introduction Body fluid volume imbalance is common in patients with kidney failure, and is associated with all‐cause mortality. This study aimed to investigate the association between fluid volume imbalance and albuminuria in patients with type 2 diabetes mellitus without kidney failure. Materials and Methods Using data from one cohort study, a baseline cross‐sectional study of 432 participants and a longitudinal cohort study of 368 participants who could follow up was carried out. Body fluid imbalance was determined by measuring the extracellular water (ECW)‐to‐intracellular water (ICW) ratio (ECW/ICW) using bioelectrical impedance analysis. A change in the urinary albumin‐to‐creatinine ratio (ACR) was defined as the ratio of urinary ACR at follow up to that at baseline. The ECW/ICW ratio was compared with the level of albuminuria. Results In this cross‐sectional study, the ECW/ICW ratio increased with the level of albuminuria. There was an association between the ECW/ICW ratio and logarithms of urinary ACR after adjusting for covariates (β = 0.205, P < 0.001). Furthermore, the ECW/ICW ratio was associated with a change in the urinary ACR after adjusting for covariates (β = 0.176, P = 0.004) in this longitudinal study. According to the receiver operating characteristic curve, the optimal cut‐off point of the ECW/ICW ratio for incident macroalbuminuria, defined as ACR >300 mg/gCr, was 0.648 (area under the curve 0.78, 95% confidence interval 0.58–0.90). Conclusions The ECW/ICW ratio is independently associated with the level of albuminuria in patients with type 2 diabetes mellitus without kidney failure. This reinforces the importance of monitoring fluid balance in patients with type 2 diabetes mellitus.

show abstract

“…All groups except the Non-DM-Early-CKD group had excess ECF above 0.39. Excess ECF in CKD patients is associated with increased risk of coronary calcification [ 23 ]. BMI was higher in the DM-CKD group than the Non-DM-CKD group for both men and women.…”

Section: Discussionmentioning

confidence: 99%

Foods contributing to nutrients intake and assessment of nutritional status in pre-dialysis patients: a cross-sectional study

et al. 2020

View full text Add to dashboard Cite

Background For chronic kidney disease (CKD) patients, management of nutritional status is critical for delaying progression to end-stage renal disease. The purpose of this study is to provide the basis for personalized nutritional intervention in pre-dialysis patients by comparing the foods contributing to nutrients intake, nutritional status and potential dietary inflammation of CKD patients according to the diabetes mellitus (DM) comorbidity and CKD stage. Methods Two hundred fifty-six outpatients referred to the Department of Nephrology at SNUH from Feb 2016 to Jan 2017 were included. Subjects on dialysis and those who had undergone kidney transplantation were excluded. Bioelectrical impedance analysis (BIA), subjective global assessment (SGA), dietary intake, and biochemical parameters were collected. Subjects were classified into 4 groups according to DM comorbidity (DM or Non-DM) and CKD stage (Early or Late) by kidney function. Two-way analysis of variance and multinomial logistic regression analysis were performed for statistical analysis. Results Total number of malnourished patients was 31 (12.1%), and all of them were moderately malnourished according to SGA. The body mass index (BMI) of the DM-CKD group was significantly higher than the Non-DM-CKD group. The contribution of whole grains and legumes to protein intake in the DM-CKD group was greater than that in the Non-DM-CKD group. The DM- Early-CKD group consumed more whole grains and legumes compared with the Non-DM-Early-CKD group. The subjects in the lowest tertile for protein intake had lower phase angle, SGA score and serum albumin levels than those in the highest tertile. The potential for diet-induced inflammation did not differ among the groups. Conclusions Significant differences in intakes of whole grains and legumes between CKD patients with or without DM were observed. Since contribution of whole grains and legumes to phosphorus and potassium intake were significant, advice regarding whole grains and legumes may be needed in DM-CKD patients if phosphorus and potassium intake levels should be controlled. The nutritional status determined by BIA, SGA and serum albumin was found to be different depending on the protein intake. Understanding the characteristics of food sources can provide a basis for individualized nutritional intervention for CKD patients depending on the presence of diabetes.

show abstract

Extracellular Fluid Excess Is Significantly Associated With Coronary Artery Calcification in Patients With Chronic Kidney Disease

Cited by 27 publications

References 53 publications

Effects of Water Restriction and Water Replenishment on the Content of Body Water with Bioelectrical Impedance among Young Adults in Baoding, China: A Randomized Controlled Trial (RCT)

Effects of Water Restriction and Water Replenishment on the Content of Body Water with Bioelectrical Impedance among Young Adults in Baoding, China: A Randomized Controlled Trial (RCT)

Impact of extracellular‐to‐intracellular fluid volume ratio on albuminuria in patients with type 2 diabetes: A cross‐sectional and longitudinal cohort study

Foods contributing to nutrients intake and assessment of nutritional status in pre-dialysis patients: a cross-sectional study

Contact Info

Product

Resources

About