Evidence mapPaperPMID 32730268Full record

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.

Byoung-Geun Han, Jun Young Lee, Mi Ryung Kim, Hanwul Shin, Jae-Seok Kim, Jae-Won Yang, Jong Yeon Kim

Open access · goldAbstract read
In one paragraph

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.

0numbers the graph read from it
0cells of the map it votes in
14citing papers in PubMed, 1 pooled it
1.5field-weighted citation impact, top 15% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

14 citing papers in PubMed, 1 synthesis or guideline pooled it, 23 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 1 institution in 1 country.

Byoung-Geun HanDepartment of Nephrology, Yonsei University Wonju College of Medicine, Wonju, Kang-won, Korea.ORCID 0000-0002-3246-2993
Jun Young LeeDepartment of Nephrology, Yonsei University Wonju College of Medicine, Wonju, Kang-won, Korea.ORCID 0000-0001-8047-4190
Mi Ryung KimDepartment of Nephrology, Yonsei University Wonju College of Medicine, Wonju, Kang-won, Korea.
Hanwul ShinDepartment of Nephrology, Yonsei University Wonju College of Medicine, Wonju, Kang-won, Korea.
Jae-Seok KimDepartment of Nephrology, Yonsei University Wonju College of Medicine, Wonju, Kang-won, Korea.
Jae-Won YangDepartment of Nephrology, Yonsei University Wonju College of Medicine, Wonju, Kang-won, Korea.
Jong Yeon KimDepartment of Neurosurgery, Yonsei University Wonju College of Medicine, Wonju, Kang-won, Korea.ORCID 0000-0002-9407-0127
Yonsei University · KR

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

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.

Indexed as

Fluid TherapyAgedDiabetes Mellitus, Type 2Dielectric SpectroscopyEchocardiographyFemaleGlomerular Filtration RateHumansHypertrophy, Left VentricularKidney Failure, ChronicLinear ModelsMaleMiddle AgedNatriuretic Peptide, BrainPeptide FragmentsPrevalenceNatriuretic Peptide, BrainPeptide Fragmentspro-brain natriuretic peptide (1-76)

Identifiers

PMID32730268
PMCPMC7392282
OpenAlexW3046341155

What Socratic holds

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LicenceCC BY
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.