Body fluid volume imbalance is common in patients with kidney failure and is associated with all-cause mortality. We hypothesized that fluid volume imbalance occurs in diabetic patients without kidney failure and is associated with albuminuria. This study aimed to investigate the association between fluid volume imbalance and albuminuria in patients with type 2 diabetes without kidney failure. Body fluid imbalance was determined by measuring the extracellular water to intracellular water ratio (ECW/ICW) using bioelectrical impedance analysis. In the cross-sectional study of 432 participants, ECW/ICW increased with level of albuminuria (0.634 ± 0.002 in normo-, 0.645 ± 0.003 in micro- and 0.656 ± 0.004 in macroalbuminuria, all p <0.001 by Tukey’s HSD test). The log-transformed urinary ACR was associated with elevated ECW/ICW ratio (r =0.313, p <0.001) (Figure). In addition, there was an association between ECW/ICW ratio and logarithms urinary ACR after adjusting for covariates (β = 0.217, p <0.001) by multiple regression analysis. Moreover, in the retrospective studies of 368 participants, ECW/ICW was associated with change in the urinary ACR after adjusting for covariates (β = 0.171, p = 0.005) by multiple regression analysis. This reinforces the importance of monitoring fluid balance in diabetic patients.


H. Nakajima: None. Y. Hashimoto: None. T. Senmaru: None. H. Okada: None. M. Hamaguchi: None. M. Fukui: None.

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