ArticlePloS one2017
Extracellular overhydration linked with endothelial dysfunction in the context of inflammation in haemodialysis dependent chronic kidney disease.
Article in PloS one, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 43 papers.
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Who cites it
43 citing papers in PubMed, 74 citations in OpenAlex.
- Negative impact of very mild volume overload on the heart function in patients on chronic hemodialysis.Renal failure · 2026Observational
- Why are SGLT2 inhibitors effective in HFpEF? Implications for interstitial fluid retention and cardio-renal interaction.Hypertension research : official journal of the Japanese Society of Hypertension · 2026Review
- Ratio of extracellular water and body cell mass is associated with coronary artery calcification in peritoneal dialysis patients.Frontiers in medicine · 2026Article
- Extracellular-to-total body water ratio is associated with comorbidity and cardiorespiratory fitness in older adults with post-COVID-19 syndrome.Frontiers in nutrition · 2026Article
- Risk factors for the development of intradialytic hypotension in patients undergoing maintenance hemodialysis.International urology and nephrology · 2025Article
- Increased risk of cardiac death with cumulative exposure to fluid overload and dialysate sodium ≤138 mmol/l in hemodialysis patients.Clinical kidney journal · 2025Article
- Aortic Pulse Wave Velocity and Extracellular Water Expansion in Hemodialysis Patients.Artificial organs · 2025Article
- Nonatherosclerotic Cardiovascular Disease in Chronic Kidney Disease.Cardiology clinics · 2025Review
- Fluid Selection in Renal Transplant Patients: Considerations for Hyperkalemia Management.Turkish journal of anaesthesiology and reanimation · 2025Article
- Practical Considerations Concerning Preeclampsia Subgroups.Journal of clinical medicine · 2025Review
- Enhanced Recovery After Surgery (ERAS) in Renal Transplantation Patients.Turkish journal of anaesthesiology and reanimation · 2025Article
- Abdominal subcutaneous fat area can predict 2-year survival in patients with end-stage renal disease initiating hemodialysis.PloS one · 2025Article
- The ratio of extracellular water to total body water serves as a potential predictor of diabetic peripheral neuropathy in patients.Frontiers in endocrinology · 2025Article
- Phase angle and extracellular edema predict risk of postoperative complications in total joint arthroplasties.Journal of electrical bioimpedance · 2025Article
- Extracellular fluid excess linked to reduced choroidal vascularity index in patients with chronic kidney disease.Scientific reports · 2024Article
- Analysis of the Associations of Measurements of Body Composition and Inflammatory Factors with Cardiovascular Disease and Its Comorbidities in a Community-Based Study.Biomedicines · 2024Article
- Relationships between Circulating Biomarkers and Body Composition Parameters in Patients with Metabolic Syndrome: A Community-Based Study.International journal of molecular sciences · 2024Article
- Body composition differences in patients with Metabolic Dysfunction-Associated Steatotic Liver Disease.Frontiers in nutrition · 2024Article
- Acute Vascular Response to Hemodialysis as Measured by Serum Syndecan-1 and Endothelin-1 Levels as Well as Vascular Stiffness.Journal of clinical medicine · 2023Article
- A high platelet-to-lymphocyte ratio predicts all-cause mortality and cardiovascular mortality in maintenance hemodialysis patients.Renal failure · 2023Article
Corrections and comments
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Authors and funding
9 authors at 3 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundHaemodialysis (HD) patients are predisposed to dysregulated fluid balance leading to extracellular water (ECW) expansion. Fluid overload has been closely linked with outcome in these patients. This has mainly been attributed to cardiac volume overload, but the relation between abnormalities in fluid status with micro- and macrovascular dysfunction has not been studied in detail. We studied the interaction of macro- and microvascular factors in states of normal and over- hydration in HD-dependent CKD.
methodsFluid compartments [total body water (TBW) and ECW] and overhydration index (OH) were measured with Multifrequency bio-impedance (BCM). Overhydration was defined as OH/ECW>7%. Overhydration was also assessed using the ECW/TBW ratio. Macrocirculation was assessed by pulse-wave velocity (PWV) and mean arterial pressure (MAP) measurements while microcirculation through sublingual capillaroscopy assessment of the Perfused Boundary Region of the endothelial glycocalyx (PBR 5-25mcg). A panel of pro-inflammatory and vascular serum biomarkers and growth factors was analysed.
resultsOf 72 HD participants, 30 were in normohydration (N) range and 42 overhydrated according to the OH/ECW ratio. Average ECW/TBW was 0.48±0.03. Overhydrated patients had higher MAP (122.9±22.5 v 111.7±22.2mmHg, p = 0.04) and comorbidities (median Davies score 1.5 v 1.0, p = 0.03). PWV (p = 0.25) and PBR 5-25mcg (p = 0.97) did not differ between the 2 groups. However, Vascular Adhesion Molecule (VCAM)-1, Interleukin-6 and Thrombomodulin, and reduced Leptin were observed in the overhydrated group. Elevation in VCAM-1 levels (OR 1.03; 95% CI 1.01-1.06; p = 0.02) showed a strong independent association with OH/ECW>7% in an adjusted logistic regression analysis and exhibited a strong linear relationship with ECW/TBW (Bata = 0.210, p = 0.03) in an also adjusted model.
conclusionExtracellular fluid overload is significantly linked to microinflammation and markers of endothelial dysfunction. The study provides novel insight in the cardiovascular risk profile associated with overhydration in uraemia.
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