OHASHI YASUSHI1, TAI REIBIN1, AOKI TOSHIYUKI1, MIZUIRI SONOO2, OGURA TOYOKO3, TANAKA YOSHIHIDE1, OKADA TAKAYUKI1, AIKAWA ATSUSHI1, SAKAI KEN1 1Department of Nephrology, School of Medicine, Faculty of Medicine, Toho University, Tokyo; 2Division of Nephrology, Ichiyokai Harada Hospital, Hiroshima; 3Department of Nutrition, Toho University Omori Medical Center, Tokyo Introduction: Fluid imbalance due to sodium

retention and malnutrition learn more can be characterized by the ratio of extracellular water (ECW) to intracellular water (ICW). Our objectives are to investigate whether fluid imbalance between ICW and ECW is a risk factor for adverse outcomes. Methods: Body fluid composition was measured in 149 patients with chronic kidney disease from 2005 to 2009, who were followed until death, loss to follow-up, or August 2013. Patients were categorized according to the ECW/ICW ratio tertile. The ratio of ECW to total body water, calculated by the Watson formula, was used as an indicator of ECW excess. Main outcomes were adverse Selleckchem BTK inhibitor renal outcomes, as defined by a decline of 50% or more

from baseline glomerular filtration rate or initiation of renal replacement therapy, cardiovascular events, and all-cause mortality. Results: Patients with higher tertile tended to be older and have diabetes mellitus, treatment-resistant hypertension, ECW excess, decreased protein intake per calorie, lower renal function, hypoalbuminemia, and higher proteinuria and furosemide usage (P < 0.01). Compared with patients in the lowest tertile during a median 4.9-year follow-up, those in the highest tertile had the worst adverse renal outcomes (15.9 vs. 5.1 per 100 patient-years, P < 0.001), cardiovascular events (4.1 vs. 0.3 per 100 patient-years, P = 0.002), and mortality (11.2 vs. 1.3 per 100 patient-years, P < 0.001)

by Kaplan–Meier survival analysis. The adjusted hazard ratio (95% confidence intervals) for adverse renal outcomes, cardiovascular events, and all-cause mortality were 1.15 (1.03–1.26, P = 0.011), 1.12 (0.93–1.31, P = 0.217), and 1.29 (1.11–1.50, P < 0.001), respectively. Conclusion: Fluid Branched chain aminotransferase imbalance between ICW and ECW, driven by cell volume decrease and ECW excess, was associated with adverse renal outcomes and mortality. These findings emphasize the importance of cell volume retention as well as appropriate extracellular volume. CHEN SZU-CHIA1, HUANG JIUN-CHI1,2, CHANG JER-MING1,2, HWANG SHANG-JYH1, CHEN HUNG-CHUN1 1Division of Nephrology, Department of Internal Medicine, Kaohsiung Medical University Hospital; 2Department of Internal Medicine, Kaohsiung Municipal Hsiao-Kang Hospital, Kaohsiung Medical University Introduction: The P wave parameters measured by 12-lead electrocardiogram (ECG) are commonly used as noninvasive tool to assess for left atrial enlargement.