Annual change in the extracellular fluid/intracellular fluid ratio and mortality in patients undergoing maintenance hemodialysis.


Journal

Scientific reports
ISSN: 2045-2322
Titre abrégé: Sci Rep
Pays: England
ID NLM: 101563288

Informations de publication

Date de publication:
07 01 2022
Historique:
received: 20 07 2021
accepted: 20 12 2021
entrez: 8 1 2022
pubmed: 9 1 2022
medline: 1 3 2022
Statut: epublish

Résumé

We aimed to investigate whether annual change in the extracellular fluid to intracellular fluid (ΔECF/ICF) ratio can accurately predict mortality in hemodialysis patients. Totally, 247 hemodialysis patients were divided into two groups according to the median baseline ECF/ICF ratio of 0.563 and ΔECF/ICF ≥ 0% or < 0% during the first year, respectively. Thereafter, they were divided into four groups according to each cutoff point and were followed up for mortality assessment. The ECF/ICF ratio increased from 0.566 ± 0.177 to 0.595 ± 0.202 in the first year (P = 0.0016). During the 3.4-year median follow-up, 93 patients died (42 cardiovascular-specific causes). The baseline ECF/ICF ≥ 0.563 and ΔECF/ICF ≥ 0% were independently associated with all-cause mortality (adjusted hazard ratio [aHR] 4.55, 95% confidence interval [CI] 2.60-7.98 and aHR 8.11, 95% CI 3.47-18.96, respectively). The aHR for ECF/ICF ≥ 0.563 and ΔECF/ICF ≥ 0% vs. ECF/ICF < 0.563 and ΔECF/ICF < 0% was 73.49 (95% CI 9.45-571.69). For model discrimination, adding the ΔECF/ICF (0.859) alone and both the baseline ECF/ICF and ΔECF/ICF (0.903) to the established risk model (0.746) significantly improved the C-index. Similar results were obtained for cardiovascular mortality. In conclusion, the ΔECF/ICF ratio could not only predict all-cause and cardiovascular mortality but also improve predictability of mortality in hemodialysis patients.

Identifiants

pubmed: 34997150
doi: 10.1038/s41598-021-04366-6
pii: 10.1038/s41598-021-04366-6
pmc: PMC8741928
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

242

Informations de copyright

© 2022. The Author(s).

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Auteurs

Takahiro Yajima (T)

Department of Nephrology, Matsunami General Hospital, Gifu, 501-6062, Japan. yajima5639@gmail.com.

Kumiko Yajima (K)

Department of Internal Medicine, Matsunami General Hospital, Gifu, 501-6062, Japan.

Hiroshi Takahashi (H)

Division of Medical Statistics, Fujita Health University School of Medicine, Aichi, 470-1192, Japan.

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