Kidney Week

Abstract: FR-PO284

Determinants of Extracellular Volume Status in CKD Stage 3-5: A Cross-Sectional Study of Bioimpedance Analysis

Session Information

• CKD: Epidemiology and Risk Factors
  November 08, 2019 | Location: Exhibit Hall, Walter E. Washington Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: CKD (Non-Dialysis)

• 2101 CKD (Non-Dialysis): Epidemiology, Risk Factors, and Prevention

Authors

• Ohara, Ken, Jichi Medical University, Shimotsuke, Tochigi, Japan

Ken Ohara,

• Masuda, Takahiro, Jichi Medical University, Shimotsuke, Tochigi, Japan

Takahiro Masuda,

• Ono, Kazutoshi, Jichi Medical University, Shimotsuke, Tochigi, Japan

Kazutoshi Ono,

• Murakami, Takuya, Jichi Medical University, Shimotsuke, Tochigi, Japan

Takuya Murakami,

• Nagayama, Izumi, Jichi Medical University, Shimotsuke, Tochigi, Japan

Izumi Nagayama,

• Yoshizawa, Hiromichi, Jichi Medical University, Shimotsuke, Tochigi, Japan

Hiromichi Yoshizawa,

• Miki, Atsushi, Jichi Medical University, Shimotsuke, Tochigi, Japan

Atsushi Miki,

• Okada, Mari, Jichi Medical University, Shimotsuke, Tochigi, Japan

Mari Okada,

• Nakagawa, Saki, Jichi Medical University, Shimotsuke, Tochigi, Japan

Saki Nakagawa,

• Hishida, Erika, Jichi Medical University, Shimotsuke, Tochigi, Japan

Erika Hishida,

• Kohara-Miura, Marina, Jichi Medical University, Shimotsuke, Tochigi, Japan

Marina Kohara-Miura,

• Kawamata, Mutsumi, Jichi Medical University, Shimotsuke, Tochigi, Japan

Mutsumi Kawamata,

• Oka, Kentaro, Jichi Medical University, Shimotsuke, Tochigi, Japan

Kentaro Oka,

• Asakura, Maki, Jichi Medical University, Shimotsuke, Tochigi, Japan

Maki Asakura,

• Shuto-Kaneko, Miwa, Jichi Medical University, Shimotsuke, Tochigi, Japan

Miwa Shuto-Kaneko,

• Kaminaga, Hiroaki, Jichi Medical University, Shimotsuke, Tochigi, Japan

Hiroaki Kaminaga,

• Hirata, Mami, Jichi Medical University, Shimotsuke, Tochigi, Japan

Mami Hirata,

• Miyazawa, Yasuharu, Nasu-Minami Hospital, Nasukarasuyama, Tochigi, Japan

Yasuharu Miyazawa,

• Maeshima, Akito, Jichi Medical University, Shimotsuke, Tochigi, Japan

Akito Maeshima,

• Akimoto, Tetsu, Jichi Medical University, Shimotsuke, Tochigi, Japan

Tetsu Akimoto,

• Saito, Osamu, Jichi Medical University, Shimotsuke, Tochigi, Japan

Osamu Saito,

• Nagata, Daisuke, Jichi Medical University, Shimotsuke, Tochigi, Japan

Daisuke Nagata,

Background

Extracellular volume expansion predicts higher mortality and adverse cardio-renal outcomes in patients with chronic kidney disease (CKD). The higher value of the extracellular water (ECW) to total body water (TBW) ratio (ECW/TBW) measured by bioimpedance analysis (BIA) is a marker of extracellular volume expansion. However, the determinants of the ECW/TBW in CKD stage 3-5 have not yet been fully evaluated.

Methods

One hundred and one non-dialysis CKD patients (stage 3-5) were enrolled in this study. Body fluid volume including intracellular water (ICW), ECW and TBW was measured by bioelectrical impedance analysis device (InBody S10).

Results

Average values are the following: age 63.7±14.5 years, male 61.4%, body mass index (BMI) 24.8±4.7, systolic blood pressure 135±20 mmHg, estimated glomerular filtration rate (eGFR) 33.3±16.4 mL/min/1.73m², hemoglobin 11.6±2.3 g/dL, serum albumin 3.4±0.8 g/dL and the ECW/TBW 0.393±0.028 (normal range 0.36-0.39). The ECW/TBW correlated positively with age (r=0.373, p=0.0001), systolic blood pressure (r=0.248, p=0.014), and ECW (r=0.336, p=0.0006), while it correlated negatively with hemoglobin (r=-0.328, p=0.001), eGFR (r=-0.398, p<0.0001) and serum albumin (r=-0.533, p<0.0001). On the other hand, the ECW/TBW was not correlated with BMI (r=0.087, p=0.385), serum Na (r=-0.074, p=0.463), ICW (r=-0.146, p=0.146) and TBW (r=0.056, p=0.581), respectively. A stepwise multiple regression analysis revealed that serum albumin (p＜0.0001), age (p=0.0002) and eGFR (p=0.0002) were independent determinants of the ECW/TBW.

Conclusion

Low serum albumin, high age and low eGFR are independently associated with higher extracellular volume status in CKD stage 3-5. Further prospective studies are needed to evaluate the impact of extracellular volume status and these factors on long-term outcomes.

Funding

• Private Foundation Support