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Copyright of Nefrologia is the property of Revista Nefrologia and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background/Aims: Lower serum sodium levels have been associated with increased mortality among patients with chronic kidney disease (CKD). Our aim was to analyze the independent factors associated with lower sodium levels among nondialysis patients with advanced CKD and to evaluate the evolution of these patients in comparison to those with higher plasma sodium over a 1-year period. Methods: We included 72 patients with CKD stages 4 and 5 without clinically evident cardiopathy or liver disease. Bioelectrical impedance and echocardiography were performed to analyze the possible relation between plasma sodium and volume status and subclinical left ventricular (LV) dysfunction. During follow-up, we compared the evolution of patients with lower baseline plasma sodium (low quartile: <138 mEq/l) with that of patients with higher levels over a 1-year period. Results: At baseline, the independent predictors of lower plasma sodium were C-reactive protein (CRP; OR 0.96; 95% CI 0.91-0.99) and body mass index (OR 0.89; 95% CI 0.78-0.99). An inverse correlation between plasma sodium and CRP was observed (r = -0.32; p = 0.01). Plasma sodium did not correlate with extracellular water and was not different between patients with or without echocardiographic data of LV dysfunction (p = 0.7). During follow-up, patients with lower sodium at baseline showed persistently lower sodium values (p = 0.04), higher CRP (p = 0.05), lower serum albumin (p < 0.01) and higher erythropoietin-stimulating agent resistance index (p = 0.05). Conclusions: Our results suggest an association between lower plasma sodium and a microinflammatory state among patients with advanced CKD. Inflammation could be an underlying confounding factor explaining the increased mortality in these patients. © 2014 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

Copyright of Nefrologia is the property of Revista Nefrologia and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: Testosterone deficiency (hypogonadism) is common among men undergoing haemodialysis, but its clinical implications are not well characterized. Testosterone is an anabolic hormone that induces erythrocytosis and muscle synthesis. We hypothesized that testosterone deficiency would be associated with low muscle mass, physical inactivity and higher dosages of erythropoietin-stimulating agents (ESA)., Methods: Single-center cross-sectional study of 57 male haemodialysis patients. None of the patients was undergoing testosterone replacement therapy. Total testosterone was measured in serum. Body composition (by bioelectrical impedance analysis) and physical activity (by the use of pedometers) were assessed. Patients with testosterone levels below the normal range were considered hypogonadal., Results: Mean testosterone level was 321±146ng/dL; 20 patients (35%) were hypogonadal. Hypogonadal patients were older and had lower mean arterial blood pressure, higher interleukin-6 levels, lower lean body mass and higher fat body mass. A negative association between testosterone and normalized ESA dose was found in uni- and multivariate regression analyses. Testosterone levels directly correlated with lean body mass regardless of confounders. Hypogonadal patients had lower physical activity than their counterparts [2753±1784 vs. 4291±3225steps/day (p=0.04)]. The relationship between testosterone and physical activity was independent of age, comorbidities and inflammatory markers, but dependent on the proportion of muscle mass., Conclusion: Hypogonadism is common in our male haemodialysis population and is associated with higher ESA doses, reduced muscle mass and lower physical activity. The link between low testosterone levels and physical inactivity may conceivably relate to reduced muscle mass due to inadequate muscle protein synthesis., (Copyright © 2016 Sociedad Española de Nefrología. Published by Elsevier España, S.L.U. All rights reserved.)

Background: Chronic fluid overload is frequent in hemodialysis patients (P) and it associates with hypertension, left ventricular hypertrophy (LVH) and higher mortality. Moreover, echocardiographic data assessing fluid overload is limited. Our aim was to evaluate the relationship between fluid overload measured by bioimpedance spectroscopy (BIS) and different echocardiographic parameters., Methods: Cross-sectional observational study including 76 stable patients. Dry weight was clinically assessed. BIS and echocardiography were performed. Weekly time-averaged fluid overload (TAFO) and relative fluid overload (FO/ECW) were calculated using BIS measurements., Results: Based on TAFO three groups were defined: A- dehydrated, TAFO <-0.25 L 32 P (42%); B- normohydrated, TAFO between -0.25 and 1.5 l: 26 (34%); C- overhydrated, TAFO>1.5 l: 18 (24%). We found significant correlation between TAFO and left atrial volume index (LAVI) (r: 0.29; p=0.013) but not with FO/ECW (r 0.06; p=0.61). TAFO, but not FO/ECW kept a significant relationship with LAVI (p=0.03) using One-Way ANOVA test and linear regression methods. LVH was present in 73.7% (concentric 63.2%, eccentric in 10.5%). No differences between groups in the presence of LVH or left ventricular mass index were found., Conclusions: We found that left atrial volume index determined by echocardiographic Area-length method, but not left ventricle hypertrophy or dimensions of cavities, are related on hydration status based on bioimpedance measured time-averaged fluid overload (TAFO), and not with FO/ECW., (Copyright © 2016 Sociedad Española de Nefrología. Published by Elsevier España, S.L.U. All rights reserved.)

Introduction: Proper hydration is one of the major aims in haemodialysis (HD) and peritoneal dialysis (PD). Bioimpedance spectroscopy appears to be a promising method for the evaluation and follow up of the hydration status in dialysis patients (P)., Objectives: We compared body composition between stable patients on HD and PD after six months., Patients and Method: An observational study with 62 P on HD and 19 P on PD was performed. Clinical, biochemical and bioimpedance parameters were analysed., Results: In the comparative study, PD P were younger (50 ± 10 vs 57 ± 14 years, P=.031). The Charlson Comorbidity Index (4.8 ± 3 vs 7.5 ± 3, P<.001), time on dialysis (16.9 ± 18.01 vs 51.88 ± 68.79 months, P=.020) and C-Reactive Protein [3 (3-9.3) vs 5.25 (1-76.4)] were lower. Total protein levels (7.46 ± 0.44 vs 7.04 ± 0.55 g/dl, P=.005) and transferrin levels (205 ± 41 vs 185 ± 29 mg/dl, P=.024) were higher. BIS: Intracellular water (19.67 ± 3.61 vs 16.51 ± 3.36 litres, P=.010), lean tissue mass (LTM) (37.20 ± 8.65 vs 32.57 ± 8.72 kg, P=.029), total cellular mass (TCM) (20.53 ± 5.65 vs 17.56 ± 5.91 kg, P=.033), and bioelectrical impedance phase angle (Phi 50) (5.81 ± 0.86 vs 4.74 ± 0.98, P=.000) were higher than in HD P. Overhydration: 22% in HD y 10% in PD, in conditions referred to in methods. Six months later, PD P increased in weight (73.75 ± 12.27 vs 75.22 ± 11.87 kg, P=.027), total fat (FAT) (26.88 ± 10 vs 30.02 ± 10 kg, P=.011) and relative fat (Rel FAT) (35.75 ± 9.87 vs 39.34 ± 9.12, P=.010); and decreased in ICW (18.56 ± 3.45 vs 17.65 ± 3.69 l, P=.009), LTM (36.95 ± 8.88 vs 34 ± 9.70 kg, P=.008) and relative LTM (Rel LTM) (50.85 ± 12.33 vs 45.40 ± 11.95%, P=.012). In the multivariate analysis, weight variation (∆) was related to ∆ FAT (P < .001). We found a correlation between fat increase and lean tissue mass decrease. Six months later, in HD P, we observed a reduction in ECW (15.11 ± 2.45 vs 14.00 ± 2.45, P.001), without changes in other parameters., Conclusions: Bioelectrical impedance analysis facilitates the assessment of changes in body composition so as to correct dry weight and to introduce changes in treatment schedule..