Extracellular Fluid/Intracellular Fluid Volume Ratio as a Novel Risk Indicator for All-Cause Mortality and Cardiovascular Disease in Hemodialysis Patients
Publication Date
January 18, 2017
Authors
Eun Jung Kim, Myung Jin Choi, Jeoung Hwan Lee, Ji Eun Oh, et al
Volume
12
Issue
1
Pages
e0170272
DOI
https://dx.plos.org/10.1371/journal.pone.0170272
Publisher URL
http://journals.plos.org/plosone/article?id=10.1371%2Fjournal.pone.0170272
Scopus
85009881911
Mendeley
http://www.mendeley.com/research/extracellular-fluidintracellular-fluid-volume-ratio-novel-risk-indicator-allcause-mortality-cardiova
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Mendeley | Further Information

{"title"=>"Extracellular Fluid/Intracellular Fluid Volume Ratio as a Novel Risk Indicator for All-Cause Mortality and Cardiovascular Disease in Hemodialysis Patients", "type"=>"journal", "authors"=>[{"first_name"=>"Eun-Jung", "last_name"=>"Kim"}, {"first_name"=>"Myung-Jin", "last_name"=>"Choi"}, {"first_name"=>"Jeoung-Hwan", "last_name"=>"Lee"}, {"first_name"=>"Ji-Eun", "last_name"=>"Oh"}, {"first_name"=>"Jang-Won", "last_name"=>"Seo"}, {"first_name"=>"Young-Ki", "last_name"=>"Lee"}, {"first_name"=>"Jong-Woo", "last_name"=>"Yoon"}, {"first_name"=>"Hyung-Jik", "last_name"=>"Kim"}, {"first_name"=>"Jung-Woo", "last_name"=>"Noh"}, {"first_name"=>"Ja-Ryong", "last_name"=>"Koo"}], "year"=>2017, "source"=>"PLOS ONE", "identifiers"=>{"issn"=>"1932-6203", "pmid"=>"28099511", "doi"=>"10.1371/journal.pone.0170272", "isbn"=>"1111111111"}, "id"=>"8e794383-f928-336a-8900-bd924c6b2dfd", "abstract"=>"BACKGROUND In hemodialysis patients, fluid overload and malnutrition are accompanied by extracellular fluid (ECF) expansion and intracellular fluid (ICF) depletion, respectively. We investigated the relationship between ECF/ICF ratio (as an integrated marker reflecting both fluid overload and malnutrition) and survival and cardiovascular disease (CVD) in the context of malnutrition-inflammation-arteriosclerosis (MIA) complex. METHODS Seventy-seven patients from a single hemodialysis unit were prospectively enrolled. The ECF/ICF volume was measured by segmental multi-frequency bioimpedance analysis. MIA and volume status were measured by serum albumin, C-reactive protein (CRP), pulse wave velocity (PWV) and plasma B-type natriuretic peptide (BNP), respectively. RESULTS The mean ECF/ICF ratio was 0.56±0.06 and the cut-off value for maximum discrimination of survival was 0.57. Compared with the low ECF/ICF group, the high ECF/ICF group (ratio≥0.57, 42%) had higher all-cause mortality, CVD, CRP, PWV, and BNP, but lower serum albumin. During the 5-year follow-up, 24 all-cause mortality and 38 CVD occurred (18 and 24, respectively, in the high ECF/ICF group versus 6 and 14 respectively in the low ECF/ICF group, P<0.001). In the adjusted Cox analysis, the ECF/ICF ratio nullifies the effects of the MIA and volume status on survival and CVD and was an independent predictor of all-cause mortality and CVD: hazard ratio (95% confidence interval); 1.12 (1.01-1.25) and 1.09 (1.01-1.18) for a 0.01 increase in the ECF/ICF ratio. The degree of malnutrition (albumin), inflammation (CRP), arteriosclerosis (PWV), and fluid overload (BNP) were correlated well with the ECF/ICF ratio. CONCLUSIONS Hemodialysis patients with high ECF/ICF ratio are not only fluid overloaded, but malnourished and have stiff artery with more inflammation. The ECF/ICF ratio is highly related to the MIA complex, and is a major risk indicator for all-cause mortality and CVD.", "link"=>"http://www.mendeley.com/research/extracellular-fluidintracellular-fluid-volume-ratio-novel-risk-indicator-allcause-mortality-cardiova", "reader_count"=>12, "reader_count_by_academic_status"=>{"Researcher"=>3, "Student > Doctoral Student"=>1, "Student > Ph. D. Student"=>1, "Student > Postgraduate"=>4, "Student > Master"=>2, "Lecturer > Senior Lecturer"=>1}, "reader_count_by_user_role"=>{"Researcher"=>3, "Student > Doctoral Student"=>1, "Student > Ph. D. Student"=>1, "Student > Postgraduate"=>4, "Student > Master"=>2, "Lecturer > Senior Lecturer"=>1}, "reader_count_by_subject_area"=>{"Engineering"=>2, "Unspecified"=>1, "Nursing and Health Professions"=>1, "Medicine and Dentistry"=>5, "Neuroscience"=>1, "Arts and Humanities"=>1, "Sports and Recreations"=>1}, "reader_count_by_subdiscipline"=>{"Engineering"=>{"Engineering"=>2}, "Medicine and Dentistry"=>{"Medicine and Dentistry"=>5}, "Neuroscience"=>{"Neuroscience"=>1}, "Sports and Recreations"=>{"Sports and Recreations"=>1}, "Nursing and Health Professions"=>{"Nursing and Health Professions"=>1}, "Unspecified"=>{"Unspecified"=>1}, "Arts and Humanities"=>{"Arts and Humanities"=>1}}, "group_count"=>0}

Scopus | Further Information

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