ATLANTA—Fluid overload in patients with late-stage chronic kidney disease (CKD) is an independent risk factor for rapid renal disease progression and maintenance dialysis, and it is a stronger predictor of these outcomes than diabetes, according to a Taiwanese study presented at the American Society of Nephrology’s Kidney Week 2013 meeting.
Yi-Chun Tsai, MD, and colleagues at the Kaohsiung Medical University Hospital in Taiwan studied 472 patients with stage 4-5 CKD. During a median follow-up of 17.3 months, 71 patients started maintenance dialysis and 187 patients presented with rapid renal progression.
“Fluid overload is one of the major presentations in patients with late stage CKD,” the authors noted. “Diabetes is the leading cause of renal failure and progression of diabetic nephropathy has been associated with changes in extracellular fluid volume.”
Compared with non-diabetic patients without fluid overload, diabetic patients with fluid overload had a 4.5-fold and 2.8-fold adjusted risk of starting maintenance dialysis and progression of renal disease, respectively. The adjusted risk of starting maintenance dialysis increased by nearly threefold among non-diabetic patients with fluid overload compared with those without fluid overload.
The researchers found no significant increased risk for renal disease progression between diabetic and non-diabetic patients without fluid overload.