[Which biological parameters for volemic status estimation?]

Area of Science:

• Nephrology
• Endocrinology
• Internal Medicine

Background:

• Accurate estimation of volemic status is crucial for diagnosing hydro-electrolytic disorders like hyponatremia and dyskalemia.
• Traditional clinical examination and biological markers often lack sufficient discriminatory power.
• Identifying reliable biological parameters for volemic status assessment is essential.

Purpose of the Study:

• To identify biological parameters that correlate strongly with volemic status.
• To find more accurate markers than current clinical and biological assessments.
• To improve the diagnosis of fluid balance disorders.

Main Methods:

• Volemic status assessed via extracellular fluid volume (using inulin distribution) in patients without edema or cardiac/hepatic insufficiency.
• Patients categorized into hypovolemic, normovolemic, and hypervolemic groups.
• Comparison and correlation of clinical and biological parameters with extracellular fluid volume.

Main Results:

• No significant differences observed in clinical parameters, plasma proteins, or urinary sodium excretion between groups.
• Fasting calcium/creatinine ratio showed strong correlation with extracellular fluid volume (r=0.51, P<0.0001).
• Fasting urinary pH (r=0.43, P<0.0001) and plasma uric acid (r=-0.39, P=0.002) also demonstrated significant correlations.

Conclusions:

• Fasting calciuria (calcium/creatinine ratio) and fasting urinary pH are potentially useful biological markers for estimating volemic status.
• These markers, along with plasma uric acid, can aid in assessing fluid balance.
• The findings offer improved diagnostic tools for hydro-electrolytic disorders.