Kidney Week

Abstract: SA-PO867

U-EVE, a Method for Estimating the Extra-Cellular Fluid Volume with Serum Uric Acid Concentrations, Would Help to Find Latent Overhydration of Hemodialysis Patients

Session Information

• Dialysis: Cardiovascular, BP, Volume
  October 27, 2018 | Location: Exhibit Hall, San Diego Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Dialysis

• 701 Dialysis: Hemodialysis and Frequent Dialysis

Authors

• Ito, Takahito, Kataguilli Medical Center, Shibata, Japan

Takahito Ito,

• Shinzato, Takahiro, Daiko Medical Engineering Research Institute, Nagoya-shi,, Japan

Takahiro Shinzato,

• Shibata, Kazuhiko, Yokohama Minami Clinic, Yokohama, Japan

Kazuhiko Shibata,

• Nakai, Shigeru, Fujita Health University School of Health Scieneces, Toyoake, Aichi, Japan

Shigeru Nakai,

• Aoki, Takeshi, Nagoya Municipal Industrial Research Institute, Iwakura-shi, Aichi-ken, Japan

Takeshi Aoki,

Background

We have developed a new method to estimate the extra-cellular fluid volume after HD (ECVa) with serum uric acid (UA) concentrations at pre- and post-hemodialysis (HD) sessions, which was named UA-assisted ECV Estimation (U-EVE). We studied the clinical value of U-EVE.

Methods

Among 108 Japanese outpatients undergoing HD in Kataguilli medical center, 79 patients maintaining stable blood flow and ultrafiltration rates on the day of blood sampling were studied. They had no cardiac events at least during the last twelve months. Plasma ANP concentrations and cardio-thorax ratios (CTR) of X-ray were measured after HD. ECVa was estimated by the U-EVE method as reported separately and was standardized by the body surface area (ECVa/BSA).

Results

ECVa/BSA values were significantly high in the patients with persistent atrial fibrillation. They, however, were unaffected by sex, diabetes, dialysis modality, and past events of myocardial infarction, pacemaker implantation, aortic valve replacement, percutaneous coronary intervention, and/or coronary artery bypass grafting. In univariate analysis, serum creatinine (Cr), ANP and Kt/V correlated with ECVa/BSA [R=-0.29133 (P=0.0092), R=0.2624 (P=0.0195), and R=-0.254 (P=0.0236), respectively]. Age, HD vintage, CTR, hemoglobin, and BNP at the pre-HD session were not significant. When the subjects were categorized into four groups, ANP concentrations of Group III were significantly higher than those of Group I (Figure). The increase of ECVa/BSA during the last twelve months correlated with age (R=0.280, P=0.0162), Cr (R=-0.386, P=0.0007), and Alb (R=-0.265, P=0.023), which suggested that the increase of ECVa/BSA might reflect the progression of sarcopenia.

Conclusion

U-EVE/BSA would help to find potentially overhydrated HD patients.

The study subjects were categorized into 4 groups according to CTR and ECVa/BSA. Statistical comparison was done by Tukey-Kramer analysis. The cut-off values of CTR and ECVa/BSA were 53.0% and 10.3 L/m², respectively.

Funding

• Clinical Revenue Support