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Background: the evaluation of hydration status and body composition in patients with kidney disease is vital for proper management, since overhydration is associated with cardiovascular complications. Patients with chronic kidney disease (CKD) begin to show perceptible alterations in hydration during the intermediate stages of the disease; however, there is little information regarding the evaluation of blood volume status through bioelectrical impedance vector analysis (BIVA) in this population. Objective: to determine the association between hydration status measured with BIVA and biochemical and clinical parameters and mortality in patients with stage G3a, G3b and G4 CKD. Material and methods: a cross-sectional study was conducted with patients with stage G3a, G3b and G4 CKD who underwent bioelectrical impedance analysis (BIA). The following biochemical and clinical parameters were determined: serum and urinary albumin, hematocrit, serum electrolytes and creatinine, estimated glomerular filtration rate (eGFR, using the CKD-EPI formula), 24-hour urine output and blood pressure. The clinical and biochemical variables were associated with the components of the BIA. According to the resistance/height (R/H) and reactance/height (Xc/H) values, the BIVA results were individually plotted on reference ellipses to identify patients with abnormal hydration states. The patients were classified by group according to hydration status and CKD stage z-scores, and differences in clinical, biochemical and BIA parameters were identified. Mortality was determined by hydration status. Results: a total of 138 subjects, 69 men and 69 women, were studied. An association was found between the BIVA components (R/H, Xc/H and phase angle (PA) and serum albumin (albumin and R/H, r = -0.38, p = 0.001; Xc, r = 0.59, p = 0.000; PA, r = 0.58, p ≤ 0.0010). When the biochemical and clinical parameters were compared by hydration status, significant differences were found in eGFR (p = 0.01), serum calcium (p ≤ 0.001), serum albumin (p ≤ 0.001), hemoglobin (p = 0.04), hematocrit, (p = 0.04) and mean arterial pressure (p = 0.03). The patients were followed for a median of 65.5 months (IQR: 53.0 to 207.0), and 12 (8.6 %) patients with CKD died. The Kaplan-Meier curves showed that patients with overhydration had a significantly higher risk of death than patients with normal hydration. Conclusions: there is an association between the hydration status evaluated by BIVA and clinical and biochemical variables. Patients with overhydration are significantly more likely to die than patients with normal hydration. [ABSTRACT FROM AUTHOR]

Introduction: Background: the evaluation of hydration status and body composition in patients with kidney disease is vital for proper management, since overhydration is associated with cardiovascular complications. Patients with chronic kidney disease (CKD) begin to show perceptible alterations in hydration during the intermediate stages of the disease; however, there is little information regarding the evaluation of blood volume status through bioelectrical impedance vector analysis (BIVA) in this population. Objective: to determine the association between hydration status measured with BIVA and biochemical and clinical parameters and mortality in patients with stage G3a, G3b and G4 CKD. Material and methods: A cross-sectional study was conducted with patients with stage G3a, G3b and G4 CKD who underwent bioelectrical impedance analysis (BIA). The following biochemical and clinical parameters were determined: serum and urinary albumin, hematocrit, serum electrolytes and creatinine, estimated glomerular filtration rate (eGFR, using the CKD-EPI formula), 24-hour urine output and blood pressure. The clinical and biochemical variables were associated with the components of the BIA. According to the resistance/height (R/H) and reactance/height (Xc/H) values, the BIVA results were individually plotted on reference ellipses to identify patients with abnormal hydration states. The patients were classified by group according to hydration status and CKD stage z-scores, and differences in clinical, biochemical and BIA parameters were identified. Mortality was determined by hydration status. Results: a total of 138 subjects, 69 men and 69 women, were studied. An association was found between the BIVA components (R/H, Xc/H and phase angle (PA) and serum albumin (albumin and R/H, r = -0.38, p = 0.001; Xc, r = 0.59, p = 0.000; PA, r = 0.58, p ≤ 0.0010). When the biochemical and clinical parameters were compared by hydration status, significant differences were found in eGFR (p = 0.01), serum calcium (p ≤ 0.001), serum albumin (p ≤ 0.001), hemoglobin (p = 0.04), hematocrit, (p = 0.04) and mean arterial pressure (p = 0.03). The patients were followed for a median of 65.5 months (IQR: 53.0 to 207.0), and 12 (8.6 %) patients with CKD died. The Kaplan-Meier curves showed that patients with overhydration had a significantly higher risk of death than patients with normal hydration. Conclusions: there is an association between the hydration status evaluated by BIVA and clinical and biochemical variables. Patients with overhydration are significantly more likely to die than patients with normal hydration. [ABSTRACT FROM AUTHOR]

Introduction: Background: the evaluation of hydration status and body composition in patients with kidney disease is vital for proper management, since overhydration is associated with cardiovascular complications. Patients with chronic kidney disease (CKD) begin to show perceptible alterations in hydration during the intermediate stages of the disease; however, there is little information regarding the evaluation of blood volume status through bioelectrical impedance vector analysis (BIVA) in this population. Objective: to determine the association between hydration status measured with BIVA and biochemical and clinical parameters and mortality in patients with stage G3a, G3b and G4 CKD. Material and methods: A cross-sectional study was conducted with patients with stage G3a, G3b and G4 CKD who underwent bioelectrical impedance analysis (BIA). The following biochemical and clinical parameters were determined: serum and urinary albumin, hematocrit, serum electrolytes and creatinine, estimated glomerular filtration rate (eGFR, using the CKD-EPI formula), 24-hour urine output and blood pressure. The clinical and biochemical variables were associated with the components of the BIA. According to the resistance/height (R/H) and reactance/height (Xc/H) values, the BIVA results were individually plotted on reference ellipses to identify patients with abnormal hydration states. The patients were classified by group according to hydration status and CKD stage z-scores, and differences in clinical, biochemical and BIA parameters were identified. Mortality was determined by hydration status. Results: a total of 138 subjects, 69 men and 69 women, were studied. An association was found between the BIVA components (R/H, Xc/H and phase angle (PA) and serum albumin (albumin and R/H, r = -0.38, p = 0.001; Xc, r = 0.59, p = 0.000; PA, r = 0.58, p ≤ 0.0010). When the biochemical and clinical parameters were compared by hydration status, significant differences were found in eGFR (p = 0.01), serum calcium (p ≤ 0.001), serum albumin (p ≤ 0.001), hemoglobin (p = 0.04), hematocrit, (p = 0.04) and mean arterial pressure (p = 0.03). The patients were followed for a median of 65.5 months (IQR: 53.0 to 207.0), and 12 (8.6 %) patients with CKD died. The Kaplan-Meier curves showed that patients with overhydration had a significantly higher risk of death than patients with normal hydration. Conclusions: there is an association between the hydration status evaluated by BIVA and clinical and biochemical variables. Patients with overhydration are significantly more likely to die than patients with normal hydration.

Background:  The performance of the CKD-EPI and MDRD formulae for estimating glomerular filtration rate (GFR) in patients of Hispanic origin with normal renal function has been poorly explored and requires validation in Mexico. , Material and Method:  We included previously healthy Mexican adults. We obtained clinical variables and determined serum creatinine to calculate the CKD-EPI and MDRD-IDMS formulae. These results were compared with the gold standard (GFR measured by Tc99DTPA). We evaluated other clinical variables that could affect the performance of the CKD-EPI formula. , Results:  A total of 97 healthy volunteers were included, 55 males and 42 females; the mean age was 35.8 years old (18 to 73). Mean creatinine was 0.76mg/dl (±0.18). CKD-EPI performance was significantly better than MDRD-IDMS in all comparisons (bias, correlation and accuracy). The bias difference between the formulae was 6.08ml/min/1.73m2 (95% CI 2.58 to 9.58) (p<.001). Individuals with a body mass index (BMI) above 25kg/m2 displayed a better performance than the group with a lower BMI (difference of means 7.39ml/min/1.73m2; 95% CI 1.17 to 13.6 p<.02). Both formulae overestimated the GFR. BMI was significantly associated with the performance of the CKD-EPI formula (β 0.82; 95% CI 0.085 to 1.56 p=.029). , Conclusions:  In healthy Mexican adults, the CKD-EPI formula is a better predictor of the mGFR than the MDRD-IDMS formula. BMI is significantly associated with the performance of the CKD-EPI formula and is better in those with a BMI greater than 25kg/m2. Both formulae overestimate mGFR.