DETERMINATION OF VOLUME OVERLOAD BY BIOELECTRICAL IMPEDANCE ANALYSIS AND NT-PROBNP IN DIABETIC PRE-DIALYSIS PATIENTS

Acta Endocrinol (Buchar). 2016 Jan-Mar;12(1):19-25. doi: 10.4183/aeb.2016.19.

Abstract

Introduction: Diabetic chronic kidney disease has more fatal clinical progresses and this situation can be related to volume overload, which is seen more commonly in diabetic chronic kidney disease patients than in non-diabetic chronic kidney disease patients. Therefore, we examined the effect of diabetes mellitus on volume overload in newly diagnosed stage 5 chronic kidney disease patients whose volume overloads were not showing signs of improvement from renal replacement therapy.

Method: One hundred and five patients (46 diabetic, 59 non-diabetic) with end-stage chronic kidney disease, who had glomerular filtration rate (GFR) under 15 mL/min for at least three months were enrolled in this prospective study. We determined the body volume overload and configuration using a bioimpedance device. NT-proBNP levels were recorded.

Results: There was a statistically significant difference between diabetic and non-diabetic groups according to overhydration (OH, p=0.003), extracellular water (ECW, p=0.045), intracellular water (ICW, p<0.001) and OH/ECW (p=0.003). In addition, there was a statistically significant difference between groups in terms of N-terminal Pro-brain Natriuretic Peptide (NT-proBNP levels, p=0.008).

Discussion: We compared diabetic and non-diabetic end-stage chronic kidney disease patients who were not in renal replacement therapy yet. We found more volume overload and extracellular fluid volume in the diabetic group.

Keywords: Diabetic nephropathy; NT-pro BNP; Pre-dialysis chronic kidney disease patients; bioimpedance analysis.