Scholarlink

Background <p>Diabetic kidney disease (DKD) can progress even in the absence of overt albuminuria, highlighting the need for markers for evaluating nonglomerular pathways. The extracellular-to-total body water ratio (ECW/TBW), measured via bioelectrical impedance analysis (BIA), reflects systemic fluid status; however, its longitudinal relevance to DKD progression remains unclear to date.</p> Methods <p>We conducted a retrospective observational cohort study using longitudinal outpatient data from October 2020 to April 2025 at the Diabetic Kidney Disease Prevention Clinic, Oita University Hospital. A total of 40 adults with type 2 diabetes and clinically diagnosed DKD contributed 355 outpatient visits. The primary outcome was the annual rate of decline in estimated glomerular filtration rate (eGFR slope, mL/min/1.73 m<sup>2</sup>/year).</p> Results <p>Both baseline and time-averaged ECW/TBW values were negatively correlated with eGFR slope in the univariate analysis (<i>p</i> = 0.014 and 0.025, respectively) and remained significant in the multivariate models. Log-transformed urinary albumin-to-creatinine ratio (UACR) was also significantly associated with faster eGFR decline. Treatment with sodium–glucose cotransporter 2 inhibitors (SGLT2is) was associated with lower ECW/TBW values, whereas other renoprotective medications exerted more modest individual effects, with greater reductions observed with the concurrent use of multiple agents.</p> Conclusions <p>Higher ECW/TBW values were associated with faster eGFR decline in DKD, suggesting that subclinical volume overload may represent a potential nonglomerular mechanism of disease progression. This volume-related burden may be attenuated by SGLT2is therapy.</p>

错误：搜索内容不能为空，请输入英文关键词
错误：关键词超出字数限制，请精简
高级检索

Association between extracellular-to-total body water ratio and eGFR decline in diabetic kidney disease: a longitudinal cohort study

  • 期刊论文

  • 出版模式：

    开放获取

  • 发表日期：

    2026年6月19日

查看全文
  • Shotaro Miyamoto,
  • Nao Imaishi,
  • Machiko Morita,
  • Hiroki Uchida,
  • Yuko Yamazaki,
  • Miyoko Osue,
  • Yuko Hirota,
  • Mitsuhiro Okamoto,
  • Satoshi Nagai,
  • Kentaro Sada,
  • Naoki Matsuda,
  • Takaaki Noguchi,
  • Yoshinori Ozeki,
  • Takeshi Nakata,
  • Yuichi Yoshida,
  • Akihiro Fukuda,
  • Koro Gotoh,
  • Takayuki Masaki,
  • Hirotaka Shibata

摘要

Background

Diabetic kidney disease (DKD) can progress even in the absence of overt albuminuria, highlighting the need for markers for evaluating nonglomerular pathways. The extracellular-to-total body water ratio (ECW/TBW), measured via bioelectrical impedance analysis (BIA), reflects systemic fluid status; however, its longitudinal relevance to DKD progression remains unclear to date.

Methods

We conducted a retrospective observational cohort study using longitudinal outpatient data from October 2020 to April 2025 at the Diabetic Kidney Disease Prevention Clinic, Oita University Hospital. A total of 40 adults with type 2 diabetes and clinically diagnosed DKD contributed 355 outpatient visits. The primary outcome was the annual rate of decline in estimated glomerular filtration rate (eGFR slope, mL/min/1.73 m2/year).

Results

Both baseline and time-averaged ECW/TBW values were negatively correlated with eGFR slope in the univariate analysis (p = 0.014 and 0.025, respectively) and remained significant in the multivariate models. Log-transformed urinary albumin-to-creatinine ratio (UACR) was also significantly associated with faster eGFR decline. Treatment with sodium–glucose cotransporter 2 inhibitors (SGLT2is) was associated with lower ECW/TBW values, whereas other renoprotective medications exerted more modest individual effects, with greater reductions observed with the concurrent use of multiple agents.

Conclusions

Higher ECW/TBW values were associated with faster eGFR decline in DKD, suggesting that subclinical volume overload may represent a potential nonglomerular mechanism of disease progression. This volume-related burden may be attenuated by SGLT2is therapy.