Observational studyJournal of the American Heart Association2015
Association of fluid retention with anemia and clinical outcomes among patients with chronic kidney disease.
Observational study in Journal of the American Heart Association, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 36 papers.
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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.
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Who cites it
36 citing papers in PubMed, 54 citations in OpenAlex.
- Phase Angle and Extracellular Water-to-Total Body Water Ratio Measured by Bioelectrical Impedance Analysis Are Associated with Anemia and Hemoglobin Levels in Women with Type 2 Diabetes: A Cross-Sectional Study.Health science reports · 2026Article
- Clinical utility of NTproBNP as a fluid assessment and prognostic tool in PD patients.Scientific reports · 2025Article
- Impacts of Ambient Temperatures on Pediatric Anemia in Sub-Saharan Africa: A Regional Ecological Study.International journal of environmental research and public health · 2025Article
- Association of Bioelectrical Impedance Analysis Parameters with Malnutrition in Patients Undergoing Maintenance Hemodialysis: A Cross-Sectional Study.Medicina (Kaunas, Lithuania) · 2025Article
- Phase angle and water cell distribution as inflammation indicators linked to hematological markers across BMI categories.Scientific reports · 2025Article
- Article
- Global availability of medications and health technologies for kidney care: A multinational study from the ISN-GKHA.PLOS global public health · 2025Article
- Review
- Pulmonary Congestion and Anemia in Hemodialysis: The Potential Link to Inflammation.International journal of molecular sciences · 2024Observational
- Article
- Whole-body water mass and kidney function: a Mendelian randomization study.Frontiers in endocrinology · 2024Article
- Exploring Symptom Clusters in Chinese Patients with Diabetic Kidney Disease: A Network Analysis.International journal of general medicine · 2024Article
- Article
- Bioimpedance-Guided Monitoring of Volume Status in Patients With Kidney Disease: A Systematic Review and Meta-Analysis.Canadian journal of kidney health and disease · 2023Article
- Review
- Investigation of the Relationship between Lean Muscle Mass and Erythropoietin Resistance in Maintenance Haemodialysis Patients: A Cross-Sectional Study.International journal of environmental research and public health · 2022Article
- Mean corpuscular hemoglobin concentration: an anemia parameter predicting cardiovascular disease in incident dialysis patients.Journal of nephrology · 2022Article
- Mineralocorticoid Receptor Antagonist Use and Hard Renal Outcomes in Real-World Patients With Chronic Kidney Disease.Hypertension (Dallas, Tex. : 1979) · 2022Article
- Adverse Drug Reactions of Antihypertensives andFrontiers in pharmacology · 2022Article
- Application of survival classification and regression tree analysis for identification of subgroups of risk in patients with heart failure and reduced left ventricular ejection fraction.The international journal of cardiovascular imaging · 2021Observational
Corrections and comments
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Authors and funding
6 authors at 4 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundObservational studies have demonstrated an association between anemia and adverse outcomes in patients with chronic kidney disease (CKD). However, randomized trials failed to identify a benefit of higher hemoglobin concentrations, suggesting that the anemia-outcome association may be confounded by unknown factors. METHODS AND
resultsWe evaluated the influence of fluid status on hemoglobin concentrations and the cardiovascular and renal outcomes in a prospective cohort of 326 patients with stage 3 to 5 CKD. Fluid status, as defined by overhydration (OH) level measured with bioimpedance, was negatively correlated with hemoglobin concentrations at baseline (r=-0.438, P<0.001). In multivariate regression analysis, OH remained an independent predictor of hemoglobin, second only to estimated glomerular filtration rate. Patients were stratified into 3 groups: no anemia (n=105), true anemia (n=82), and anemia with excess OH (n=139) (relative OH level ≥7%, the 90th percentile for the healthy population). During a median follow-up of 2.2 years, there was no difference in cardiovascular and renal risks between patients with true anemia and those with no anemia in the adjusted Cox proportional hazards models. However, patients with anemia with excess OH had a significantly increased risk of cardiovascular morbidity and mortality and CKD progression relative to those with true anemia and those with no anemia, respectively.
conclusionsFluid retention is associated with the severity of anemia and adverse cardiovascular and renal outcomes in patients with CKD. Further research is warranted to clarify whether the correction of fluid retention, instead of increasing erythropoiesis, would improve outcomes of CKD-associated anemia.
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