ArticlePloS one2020
Fluid overload is a determinant for cardiac structural and functional impairments in type 2 diabetes mellitus and chronic kidney disease stage 5 not undergoing dialysis.
Article in PloS one, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers, 1 of them a synthesis that pooled it.
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14 citing papers in PubMed, 1 synthesis or guideline pooled it, 23 citations in OpenAlex.
- Sodium-glucose cotransporter 2 inhibitors (SGLT2i) and cardiac arrhythmias: a systematic review and meta-analysis.Cardiovascular diabetology · 2021Pooled it
- Prognostic value of valve calcification and high cardiothoracic ratio for major adverse cardiovascular events and mortality in hemodialysis patients.Renal failure · 2026Article
- The association between extracellular fluid volume and sympathetic nervous system activity in patients with chronic kidney disease.American journal of physiology. Renal physiology · 2026Article
- Prognostic value of ultrafiltration rate variability in maintenance hemodialysis patients: a prospective cohort study.Frontiers of medicine · 2025Article
- Heart rate variability tests for diagnosing cardiovascular autonomic neuropathy in patients with type 2 diabetes mellitus in advanced stages of kidney disease.Cardiovascular diabetology · 2025Article
- Prognostic Significance of Visit-to-Visit Ultrafiltration Volume Variability in Hemodialysis Patients.Biomedicines · 2025Article
- The Spectrum of Echocardiographic Findings Across Stages I-V of Chronic Kidney Disease.Cureus · 2024Article
- The Association between Echocardiographic Parameters of Heart Failure with Preserved Ejection Fraction and Fluid Status Biomarkers in Hemodialysis Patients.Diagnostics (Basel, Switzerland) · 2024Article
- The moderating effect of fluid overload on the relationship between the augmentation index and left ventricular diastolic function in patients with CKD.Scientific reports · 2024Article
- Correlation between cognitive impairment and body composition indicators in patients with chronic kidney disease after hemodialysis.American journal of translational research · 2024Article
- Whole-body water mass and kidney function: a Mendelian randomization study.Frontiers in endocrinology · 2024Article
- Comparing Left Ventricular Diastolic Function between Peritoneal Dialysis and Non-Dialysis Patients with Stage 5 Chronic Kidney Disease: A Propensity Score-Matched Analysis.Journal of clinical medicine · 2023Article
- Impact of Overhydration on Left Ventricular Hypertrophy in Patients With Chronic Kidney Disease.Frontiers in nutrition · 2022Article
- B-type natriuretic peptide levels and volume status in twice-weekly hemodialysis patients.Renal failure · 2021Article
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7 authors at 1 institution in 1 country.
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No grant is acknowledged in the PubMed record.
Abstract
backgroundFluid overload is common in patients with diabetes and chronic kidney disease (DM and CKD; DMCKD) and can lead to structural and functional cardiac abnormalities including left ventricular hypertrophy (LVH) and left ventricular diastolic dysfunction (LVDD). Fluid overload represents a crucial step in the pathophysiological pathways to chronic heart failure in patients with end-stage renal disease. We evaluated the impact of fluid overload on cardiac alterations in patients with diabetes and non-dialysis-dependent CKD stage 5 (DMCKD5-ND) without intrinsic heart disease.
methodsBioimpedance spectroscopy, echocardiography, and N-terminal prohormone of B-type natriuretic peptide (NT-proBNP) measurement were performed in 135 consecutive patients on the same day. Patients were divided into groups by tertiles of overhydration/extracellular water (OH/ECW) per bioimpedance spectroscopy.
resultsFluid balance markers including OH/ECW and NT-proBNP were significantly higher in the LVDD+LVH group. OH/ECW and its exacerbation were positively associated with the ratio between early mitral inflow and annular early diastolic velocities (E/e' ratio) and left ventricular mass index (LVMI). The prevalence of LVH progressively increased across increasing tertiles of OH/ECW. In multiple regression analyses, OH/ECW as a continuous and categorical variable was independently associated with the E/e' ratio and LVMI after adjustment for multiple confounding factors.
conclusionsFluid overload was independently associated with LVDD and LVH in patients with DMCKD5-ND. Our study suggests that structural and functional cardiac abnormalities and volume status should be evaluated simultaneously in patients with early-stage DMCKD rather than only DMCKD5-ND, in addition to intensive blood pressure and glycemic control, regardless of evident cardiovascular disease.
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