On Whether Ca-125 Is the Answer for Diagnosing Overhydration, Particularly in End-Stage Kidney Disease Patients-A Systematic Review

Int J Mol Sci. 2024 Feb 12;25(4):2192. doi: 10.3390/ijms25042192.

Abstract

Overhydration (OH) is a prevalent medical problem that occurs in patients with kidney failure, but a specific marker has still not been found. Patients requiring kidney replacement therapy suffer from a water imbalance, which is correlated with mortality rates in this population. Currently, clinicians employ techniques such as bioimpedance spectroscopy (BIS) and ultrasound (USG) markers of overhydration or markers of heart and kidney function, namely NT-pro-BNP, GFR, or creatinine levels. New serum markers, including but not limited to Ca-125, galectin-3 (Gal-3), adrenomedullin (AMD), and urocortin-2 (UCN-2), are presently under research and have displayed promising results. Ca-125, which is a protein mainly used in ovarian cancer diagnoses, holds great potential to become an OH marker. It is currently being investigated by cardiologists as it corresponds to the volume status in heart failure (HF) and ventricular hypertrophy, which are also associated with OH. The need to ascertain a more precise marker of overhydration is urgent mainly because physical examinations are exceptionally inaccurate. The signs and symptoms of overhydration, such as edema or a gradual increase in body mass, are not always present, notably in patients with chronic kidney disease. Metabolic disruptions and cachexia can give a false picture of the hydration status. This review paper summarizes the existing knowledge on the assessment of a patient's hydration status, focusing specifically on kidney diseases and the role of Ca-125.

Keywords: BIS; Ca-125; Ca-125 kidney disease; VEXUS; fluid status; heart failure; hydration status dialysis; kidney failure; overhydration; renal failure.

Publication types

  • Systematic Review
  • Review

MeSH terms

  • Biomarkers
  • CA-125 Antigen* / blood
  • CA-125 Antigen* / chemistry
  • Humans
  • Kidney Failure, Chronic* / complications
  • Renal Dialysis / adverse effects
  • Renal Insufficiency, Chronic* / complications
  • Water Intoxication* / diagnosis

Substances

  • Biomarkers
  • CA-125 Antigen

Grants and funding

This research received no external funding.