Observational studyClinical journal of the American Society of Nephrology : CJASN2015
Association of fluid overload with cardiovascular morbidity and all-cause mortality in stages 4 and 5 CKD.
Observational study in Clinical journal of the American Society of Nephrology : CJASN, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 78 papers, 1 of them a synthesis that pooled it.
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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.
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.
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Who cites it
78 citing papers in PubMed, 1 synthesis or guideline pooled it, 157 citations in OpenAlex.
- Bioimpedance-defined overhydration predicts survival in end stage kidney failure (ESKF): systematic review and subgroup meta-analysis.Scientific reports · 2018Pooled it
- Application of bioimpedance spectroscopy in Asian dialysis patients (ABISAD-III): a randomized controlled trial for clinical outcomes.International urology and nephrology · 2016Trial
- Comparison of Intradialytic Parenteral Nutrition with Glucose or Amino Acid Mixtures in Maintenance Hemodialysis Patients.Nutrients · 2016Trial
- Dual Impact of Tolvaptan on Intracellular and Extracellular Water in Chronic Kidney Disease Patients with Fluid Retention.Internal medicine (Tokyo, Japan)Trial
- Ten tips for the first hemodialysis sessions.Clinical kidney journal · 2026Review
- Characterization and outcomes of cats with cardiomyopathy undergoing subcutaneous ureteral bypass device placement.Journal of veterinary internal medicine · 2026Article
- Best Evidence Summary for Volume Management of Patients With Heart and Kidney Comorbidity.Nursing open · 2026Review
- Association of cardiometabolic index with incident cardiovascular disease in middle-aged and older adults with cardiovascular-kidney-metabolic syndrome stages 0-3: evidence from CHARLS (2011-2020).Scientific reports · 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
- Normalized creatinine-to-cystatin C ratio and cardiovascular disease risk in populations with cardiovascular-kidney-metabolic syndrome stages 0-3: findings from a national and prospective cohort study.European journal of medical research · 2026Article
- Ratio of extracellular water and body cell mass is associated with coronary artery calcification in peritoneal dialysis patients.Frontiers in medicine · 2026Article
- Association between Phase Angle and Subclinical Atherosclerosis in Asymptomatic Adults: A Large Scale Cross-Sectional and Longitudinal Study.Journal of atherosclerosis and thrombosis · 2026Article
- Frequency-domain broadband near-infrared spectroscopy for noninvasive monitoring of fluid volume status during hemodialysis.Biophotonics discovery · 2026Article
- Nonatherosclerotic Cardiovascular Disease in Chronic Kidney Disease.Cardiology clinics · 2025Review
- Non-linear association between extracellular water/total body water ratio and all-cause mortality: a population-based cohort study.Scientific reports · 2025Article
- Correlation between atherogenic index of plasma and cardiovascular disease risk across Cardiovascular-kidney-metabolic syndrome stages 0-3: a nationwide prospective cohort study.Cardiovascular diabetology · 2025Article
- Article
- Exploring Biomarkers for Excess Extracellular Fluid in the Context of Physical Function in Chronic Kidney Disease Patients.Journal of personalized medicine · 2024Article
- Estimating Dietary Protein and Sodium Intake with Sodium Removal in Peritoneal Dialysis Patients.Metabolites · 2024Article
- Plasma B-type natriuretic peptide is independently associated with cardiovascular events and mortality in patients with chronic kidney disease.Scientific reports · 2024Article
18 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
9 authors at 4 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
BACKGROUND AND
objectivesFluid overload is a common characteristic associated with renal progression in CKD. Additionally, fluid overload is an independent predictor of all-cause or cardiovascular mortality in patients on dialysis, but its influence on patients not on dialysis is uncertain. The aim of the study was to assess the relationship between the severity of fluid status and clinical outcomes in an advanced CKD cohort. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: In total, 478 predialysis patients with stages 4 and 5 CKD in the integrated CKD care program were enrolled from January of 2011 to December of 2011 and followed-up until August of 2013. The clinical outcomes included cardiovascular morbidity and all-cause mortality. The relative hydration status (overhydration/extracellular water) was used as the presentation of the severity of fluid status and measured using a body composition monitor. Overhydration/extracellular water >7% was defined as fluid overload.
resultsOver a median follow-up period of 23.2 (12.6-26.4) months, 66 (13.8%) patients reached all-cause mortality or cardiovascular morbidity. The adjusted hazard ratio of the combined outcome of all-cause mortality or cardiovascular morbidity for every 1% higher overhydration/extracellular water was 1.08 (95% confidence interval, 1.04 to 1.12; P<0.001). The adjusted overhydration/extracellular water for the combined outcome of all-cause mortality or cardiovascular morbidity in participants with overhydration/extracellular water ≥7% compared with those with overhydration/extracellular water <7% was 1.93 (95% confidence interval, 1.01 to 3.69; P=0.04). In subgroup analysis, higher overhydration/extracellular water was consistently associated with increased risk for the combined outcome independent of diabetes, cardiovascular disease, and serum albumin. There was no significant interaction between all subgroups.
conclusionsThese findings suggest that fluid overload is an independent risk factor of the combined outcome of all-cause mortality or cardiovascular morbidity in patients with advanced CKD.
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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 OpenQuestion graph.