Related Experiment Video

Updated: May 9, 2026

5/6 Nephrectomy Using Sharp Bipolectomy Via Midline Laparotomy in Rats
05:34

5/6 Nephrectomy Using Sharp Bipolectomy Via Midline Laparotomy in Rats

Published on: April 4, 2025

Association of fluid overload with kidney disease progression in advanced CKD: a prospective cohort study

Yi-Chun Tsai1, Jer-Chia Tsai2, Szu-Chia Chen3

  • 1Division of Nephrology, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.

American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation
|July 31, 2013
PubMed

Insights

Fluid overload in advanced chronic kidney disease (CKD) independently predicts faster kidney function decline and need for renal replacement therapy (RRT). Monitoring fluid status is crucial for managing CKD progression.

Area of Science:

  • Nephrology
  • Internal Medicine
  • Clinical Research

Background:

  • Fluid overload is common in advanced chronic kidney disease (CKD).
  • The relationship between fluid overload and CKD progression is not well understood.
  • This study investigates fluid status and kidney disease progression in advanced CKD.

Purpose of the Study:

  • To assess the association between fluid overload severity and kidney disease progression.
  • To determine if fluid overload is an independent risk factor for renal replacement therapy (RRT) initiation.
  • To evaluate the impact of fluid overload on the rate of estimated glomerular filtration rate (eGFR) decline.

Main Methods:

  • Prospective observational cohort study of 472 non-dialysis-dependent patients with CKD stages 4-5.
  • Fluid overload measured by bioimpedance spectroscopy, categorized into tertiles.
  • Estimated glomerular filtration rate (eGFR) calculated using the 4-variable MDRD Study equation.

Main Results:

  • During a median 17.3-month follow-up, 15.0% initiated RRT and 39.6% experienced rapid eGFR decline.
  • Higher fluid overload tertiles were associated with increased risk of RRT initiation (aHR=3.16) and rapid eGFR decline (aOR=4.68).
  • Fluid overload significantly accelerated eGFR decline over time (P=0.02).

Conclusions:

  • Fluid overload is an independent risk factor for RRT initiation in advanced CKD.
  • Fluid overload is associated with a faster decline in kidney function (eGFR).
  • Consideration of fluid volume variations is essential in managing advanced CKD patients.
Abstract

Keywords:
Fluid overloadchronic kidney diseasedialysiskidney disease progression

More Related Videos

Assessment of Vascular Function in Patients With Chronic Kidney Disease08:50

Assessment of Vascular Function in Patients With Chronic Kidney Disease

Published on: June 16, 2014

Related Concept Videos

Chronic Kidney Disease I: Introduction01:25

Chronic Kidney Disease I: Introduction

Chronic Kidney Disease (CKD) arises when the kidneys progressively lose their ability to function, ultimately leading to end-stage renal disease. At this advanced stage, the kidneys can no longer filter waste or maintain essential body functions, requiring renal replacement therapy (RRT) through dialysis or a kidney transplant for survival.Early-stage chronic kidney disease and detection challengesIn CKD's early stages, symptoms often remain absent because healthy nephrons compensate for...
Chronic Kidney Disease IV: Nursing Management01:18

Chronic Kidney Disease IV: Nursing Management

Nursing management is essential for preventing complications, maintaining stability, and improving patients' quality of life in chronic kidney disease (CKD). By using a structured approach, nurses help slow CKD progression and support effective patient care​.1. Comprehensive patient assessmentEffective management begins with nurses reviewing the patient’s medical history, and identifying key risk factors like diabetes, hypertension, and nephrotoxic drug use. Nurses assess signs of fluid...
Chronic Kidney Disease III: Interprofessional Care01:28

Chronic Kidney Disease III: Interprofessional Care

Chronic kidney disease (CKD) requires collaborative and comprehensive management. CKD progresses through stages and can lead to end-stage kidney disease (ESKD) if untreated. Interprofessional collaboration and patient education are crucial, enabling patients to manage their health and improve their quality of life.Diagnostic approach for chronic kidney diseaseThe diagnosis of CKD primarily focuses on the glomerular filtration rate (GFR), which assesses kidney function by measuring how well...
Acute Kidney Injury IV: Diagnostic Studies and Prevention01:30

Acute Kidney Injury IV: Diagnostic Studies and Prevention

Accurate diagnosis and effective prevention are critical in managing Acute Kidney Injury (AKI), which is linked to high mortality rates ranging from 10% to 80%. Timely recognition of at-risk patients and careful monitoring can significantly reduce the likelihood of kidney damage.Diagnostic Assessments:The diagnostic process starts with a comprehensive medical history to identify prerenal, intrarenal, and postrenal causes.Prerenal causes, such as dehydration, hypotension, or blood loss, should...
Heart Failure Drugs: Diuretics01:22

Heart Failure Drugs: Diuretics

Heart failure and kidney perfusion are interconnected in a complex way. Reduced renal perfusion and venous congestion are two significant factors that contribute to renal dysfunction in heart failure. The kidneys, primarily responsible for fluid balance in the body, are adversely affected due to compromised cardiac output and increased venous pressure. In response to reduced renal perfusion, the kidneys activate neurohumoral mechanisms to restore balance. However, these mechanisms can be...
Acute Kidney Injury V: Interprofessional Care01:20

Acute Kidney Injury V: Interprofessional Care

Acute Kidney Injury (AKI) requires a collaborative healthcare approach to restore renal function and prevent complications. Essential management strategies involve monitoring fluid and electrolyte balance, adjusting medications, initiating dialysis when necessary, and providing nutritional support.Fluid and Electrolyte ManagementFluid Monitoring: Regularly monitoring body weight, central venous pressure, and urine output helps detect fluid imbalances early. Patient intake and output are...