Pol Arch Intern Med. 2021 Aug 5. doi: 10.20452/pamw.16071. Online ahead of print.
ABSTRACT
Introduction Cardio-vascular mortality in end-stage renal disease patients remains high despite advancement in dialysis techniques. This can be attributed to a number of traditional and non-traditional risk factors. Overhydration seems to be one of the promising non-traditional cardio-vascular risk factors to target in order to improve the survival. Objectives The aim of this study was to assess the influence of chronic overhydration and its dynamic changes on cardio-vascular and all-cause morbidity and mortality in the group of hemodialyzed patients. Patients and methods The study has been conducted on a total number of 511 patients. Hydration was assessed with whole-body bioimpedance spectroscopy. The entire cohort has been divided into 4 subgroups according to initial hydration value. Additionally, patients with at least 2 observation visits (n = 277) have been assigned to 4 subgroups created with respect to hydration change-over-time. Results Statistical analysis showed that male gender (P <0.001), diabetes (P <0.001), heart insufficiency (P < 0.001), smoking (P = 0.049) and cerebrovascular incidents (P = 0.007) were significant risk factors for overhydration. Cardiovascular toxicity of overhydration was reflected with elevated levels of NT-proBNP (P <0.001) and cTnT (P <0.001). Albumin and total cholesterol values were the lowest in highly overhydrated subgroups (P <0.001) showing the prevalence of malnutrition. Mortality rate was significantly lower in groups of normal hydration and mild overhydration (P <0.001), as well as of patients with stable low or descending overhydration levels (P = 0.002). Conclusion We can state that the degree of overhydration of hemodialyzed patients is significantly associated with the incidence of cardiovascular complications and affects the prognosis in end-stage renal disease.
PMID:34351089 | DOI:10.20452/pamw.16071
