ASN's Mission

ASN leads the fight to prevent, treat, and cure kidney diseases throughout the world by educating health professionals and scientists, advancing research and innovation, communicating new knowledge, and advocating for the highest quality care for patients.

learn more

Contact ASN

1401 H St, NW, Ste 900, Washington, DC 20005

email@asn-online.org

202-640-4660

The Latest on Twitter

Kidney Week

Abstract: PO1877

Fluid Overload and Markers of Cardiovascular Damage in Severe Nephrotic Syndrome

Session Information

Category: Glomerular Diseases

  • 1203 Glomerular Diseases: Clinical, Outcomes, and Trials

Authors

  • Rymarz, Aleksandra, Military Institute of Medicine, Warsaw,Poland, Warsaw, Poland
  • Matyjek, Anna, Military Institute of Medicine, Warsaw,Poland, Warsaw, Poland
  • Niemczyk, Stanislaw, Military Institute of Medicine, Warsaw,Poland, Warsaw, Poland
Background

The purpose of the study was to evaluate the dimension of body water compartments and markers of cardiovascular damage in patients with severe nephrotic syndrome (SNS) defined as nephrotic range proteinuria and hypalbuminaemia ≤ 2.5 g/dl.

Methods

40 patients with SNS and eGFR >30 ml/min/1.73m2 formed the study group (SNSG) and 40 healthy volunteers without SNS matched according to age, sex, height, body mass, kidney function formed the control group (CG). Body water compartments were assessed using Body Composition Monitor, Fresenius Medical Care. For statistical analysis Spearman’s correlation coefficients, chi2 or Mann-Whitney U tests were used (Statistica v 13.1).

Results

SNSG included 28 males and 12 females, the mean daily proteinuria was 10.5±5.0 g. The groups are described in the table.
In SNSG significantly higher hsTnT, NT-proBNP and extracellular water(ECW) were observed in comparison to CG. Intracellular water (ICW) was significantly lower in comparison to CG. Total body water (TBW) did not differ between the groups. Overhydration (OH) was higher in SNSG than in CG. Significant, positive correlation was observed between OH and NT-proBNP (R=0.56, p<0.0001) as well as hsTnT (R=0.60, p<0.0001). We did not observed significant correlation between ECW and NT-proBNP or hsTnT.

Conclusion

In SNSG fluid retention was associated with the increase in ECW and the decrease in ICW whereas TBW was the same in both groups. Such constellation can indicate for intracellular underhydration which was not describe so far. OH, which is a derivative of ECW, correlated with markers of cardiovascular damage and can be important for patients with resistant SNS and influence their prognosis.

Clinical characteristic of the study groups
 Severe Nephrotic Syndrome Group (SNSG)Control Group (CG)P
GenderM: 28 (50%)
F: 12 (30%)
M: 29 (72.5%)
F: 11 (27.5%)
1.000
Age [years]55 (30-64)44 (30-64)0.736
Height [cm]170 ± 10173 ± 100.173
Body weight [kg]80.0 ± 15.577.5 ± 14.50.473
eGFR [ml/min/1,73m2]73 ± 3682 ± 270.382
Serum albumin [g/dl]2.0 ± 0.44.6 ±.0.5<0.0001
hs-TnT [ng/l]18 (8-40)6 (3-13)0.0001
NT-proBNP [pg/ml]294.8 (94-1033)47.1 (33-168)0.0003
TBW [L]39.8 ± 8.638.8 ± 7.70.603
OH [L]4.2 (3.0-6.6)0.3 (-0.2-0.6)<0.0001
ECW [L]20.9 ± 5.217.4 ± 3.30.001
ICW [L]18.9 ± 4.721.4 ± 4.80.034