672 patients were assessed for management of renal anemia during 12 months. Results 1) Mean age was 68 years and 69.2% was male gender. Percentages of diabetes and history of cardiovascular disease were 37.9% and 27.8%, respectively. Conclusion: Anemia with ID was associated with a higher risk for CV events than without ID. Compared to increasing prescription of ESA, prescription of iron Metabolism inhibitor did not increase sufficiently. These results suggest that it is necessary to assess ID and use iron supplementation appropriately. JIN KYUBOK, PARK BONG-SOO,
JEONG HEUI JEONG, KIM YANG-WOOK Department of Medicine, Inje University, Haeundae Paik Hospital Introduction: Although control of normal hydration state is a key parameter for cardiovascular mortality in
dialysis patients, the question for biomarkers of volume excess continues. Body composition monitor (BCM; Fresenius Medical care, Bad Homburg, Germany) has been proven as a non-invasive and quantitative method for measuring intracellular and extracellular fluid spaces. In addition, N-terminal pro-B-type natriuretic peptide (NT-proBNP), myeloperoxidase, copeptin and proadrenomedullin are associated with cardiac dysfunction and systemic blood volume. Present study investigated the relationship between body fluid status and volume markers in dialysis patients. Methods: Cohorts EPZ-6438 molecular weight of pre-dialysis (pre-D), hemodialysis (HD) and peritoneal dialysis (PD) patients and age- and gender-matched healthy Korean individuals were recruited in the study (N = 80). In all patients BCM and standard echocardiography were performed. HD patients were measured at the midweek session before dialysis and PD patients were measured with a full abdomen. Also mafosfamide NT-proBNP, myeloperoxidase, cepetin and proadrenomedullin as volume markers were measured. Clinical overhydration was defined as an overhydration-to-exracellular water ratio of >15%. Results: Total
body water, extracellular water and intracellular water were not different in the control, pre-D, HD and PD patients. In the control and pre-D patients, overhydration were 0.6 ± 0.2 L and 1.9 ± 1.0 L, whereas 2.8 ± 0.6 L and 3.0 ± 0.5 L in the HD and PD patients, respectively (p < 0.001). Clinical overhydration was more prevalent in HD and PD patients compared to pre-D patients (35% vs 55% vs 20%, p < 0.05). This was associated with significantly (p < 0.001) higher NT-proBNP and proadrenomedullin levels in HD and PD patients than in the control and pre-D groups. However, no significant difference was found in levels of myeloperoxidase and copeptin in the study groups. Clinical overhydration was associated with cardiac dysfunction markers (LV mass index, LV dimension and ejection fraction, LA diameter and E/E′ ratio). In multivariate models, clinical overhydration was directly related to NT-proBNP and proadrenomedullin concentrations in the study population (r = 0.454 [p < 0.001] and r = 0.505 [p < 0.001], respectively).