Características del síndrome de lisis tumoral en pacientes pediátricos oncológicos. Un estudio observacional de centro único / Characteristics of tumor lysis syndrome in pediatric oncology patients. A single-center observational study

Introducción:El síndrome de lisis tumoral (SLT) es una emergencia oncológica, que produce alteraciones en el metabolismo, causando manifestaciones clínicas y trastornos bioquímicos que ponen en peligro la vida del paciente.El objetivo del presente estudio fue identificar las características clínicas, de laboratorio y tratamiento del SLT, en pacientes pediátricos onco-lógicos, del Instituto del Cáncer SOLCA-Cuenca, en el periodo 2010 ­2020.Materiales y métodos:En este estudio se identificó las características del SLT, en pacientes pediátricos oncológicos, del Instituto del Cáncer SOLCA-Cuenca, en el periodo 2010 ­2020, a través de un estudio de tipo descriptivo-observacional.Resultados:Seincluyó 463 historias clínicas, en el cual se obtuvo que el SLT tuvo una frecuen-cia del 5.61 %, con predominio del sexo masculino (57.7%) y con una edad media de 7 ± 1.29 años. La presentación clínica más observada fue la deshidratación con náusea, vómito y dia-rrea (57.7%). Las alteraciones de laboratorio más frecuentes fueron la hiperuricemia y la hi-pocalcemia, con un 76.9 %y un 73.1 %respectivamente. La Leucemia linfoblástica aguda (LLA) fue el diagnósticooncológico con más casos (61.5 %). Los pilares del tratamiento fue-ron la hiperhidratación y el uso de alopurinol, utilizados en el 100% y un 80.8 %respectiva-mente.Conclusión:El SLT afectó más frecuentemente a varones, con diagnóstico de leucemia, ma-nifestaciones clínicas digestivas y alteraciones de laboratorio (hiperuricemia e hipocalcemia). El tratamiento empleado resultó eficaz y se basó en lo recomendado por la literatura médica

Introduction:Tumor lysis syndrome (TLS) is an oncological emergency that results in meta-bolic alterations, causing clinical manifestations and biochemical disorders that endanger pa-tients' lives. The objective of the present study was to identify the clinical, laboratory, and treat-ment characteristics of TLSsin pediatric oncology patients at the SOLCA-Cuenca Cancer Ins-titute from 2010­2020.Materials and methods: In this study, the characteristics of TLS were identified in pediatric oncology patients at the SOLCA-Cuenca Cancer Institute from 2010 to 2020 through a des-criptive observational study.Results: A total of463 medical records were included. TLSs were associated witha frequency of 5.61%, with a predominance of males(57.7%) and a mean age of 7 ± 1.29 years. The most commonclinical presentation was dehydration with nausea, vomiting, and diarrhea (57.7%). The most frequent laboratory alterations were hyperuricemia and hypocalcemia, with 76.9% and 73.1%,respectively. The oncological diagnosis was acutelymphoblastic leukemia (ALL) in most patients(61.5%). The pillars of treatment were hyperhydration and allopurinol, used in 100% and 80.8%, respectively.Conclusion: TLSsmore frequently affectmen with a diagnosis of leukemia, digestive clinical manifestations, orlaboratory alterations (hyperuricemia and hypocalcemia). The treatment used was effective and based on what the medical literature recommended

Fluid intake, hydration status and body mass changes in U-15 judo athletes during a training day

Despite numerous studies related to dehydration there is still a lack of scientific literature presenting hydration status and fluid intake of judo athletes during different periods. Therefore, the aim of this study was to investigate, fluid intake, hydration status and body weight changes of young judo athletes during a typical day of training in preparation period. Twenty-two young judo athletes (age: 12 ± 0.7 y, experience: 3.5 ± 1.1) voluntarily participated in this study. Hydration status and weight were examined in the morning, before and immediately after the training. All athletes trained 90 min and they consumed fluids ad libitum during the exercise. According to morning urine specific gravity (USG) values, 81.2% of the athletes were dehydrated while only 18.8% of the athletes were euhydrated. Pre-training urine measurements showed that 63.64% of the athletes presented dehydration and 77.27% of the athletes completed the training in dehydrated condition despite fluid availability during the training. Mean body weight loss during training was -0.64 ± 0.66%. It can be concluded that young judo athletes presented high prevalence of dehydration as indicated by USG values. Most of the athletes were dehydrated during a typical training day and completed the training in more dehydrated conditions compared to pre training values despite ad libitum fluid intake. It is of great importance to evaluate hydration status of the athletes before training to refrain from common practice of fluid restriction for weight loss and adverse effects of a persistent state of fluid deficit on physical and health related state.

Perfil de composición corporal en militares élite chilenos / Body composition profile of elite Chilean military

RESUMEN: La Bioimpedancia Eléctrica (BIA), al ser una técnica no invasiva pero de elevada precisión, se ha convertido en la actualidad en una herramienta valiosa para determinar la composición corporal en militares, facilitado el control de las distintas variables que se asocian a cada especialidad. El objetivo del presente estudio fue describir el perfil de composición corporal en militares de elite al momento de finalizar un curso de especialización. Participaron 11 militares con un rango de edad entre 22 y 29 años. Se evalúo la composición corporal a través de BIA, inmediatamente después de finalizado un curso de especialización para militares de élite. Las evaluaciones en los militares sobre las variables de la composición corporal a través de BIA mostraron: peso corporal de 84,3 ± 4,52 kg, talla 1,78 ± 0,06 m, índice de masa corporal (IMC) 26,5 ± 1,09, tejido adiposo de 13,7 ± 3,65 %, tejido muscular 49,5 ± 2,34 %, masa libre de grasa 72,7 ± 5,23 kg y 53,2 ± 3,78 l de agua corporal total. Conclusiones: Los militares de elite presentaron elevados niveles de masa libre de grasa, tejido muscular y bajos niveles de tejido adiposo lo que favorece el desarrollo de las actividades militares especializadas y disminuye el riesgo de lesiones. Los datos aquí recogidos sirven como marco de referencia para futuros estudios.

SUMMARY: Electrical bioimpedance (BIA), being a non- invasive technique but with high precision, has become a valuable tool for determining body composition in the military, facilitating the control of the different variables associated with each specialty. The aim of the present study was to describe the body composition profile of elite military personnel at the end of a specialization course. Eleven military personnel between 22 and 29 years of age participated in the study. Body composition was assessed by BIA immediately after completion of a specialization course for elite military personnel. Assessments in the military on body composition variables through BIA showed: body weight of 84.3 ± 4.52 kg, height 1.78 ± 0.06 m, body mass index (BMI) 26.5 ± 1.09, adipose tissue of 13.7 ± 3.65 %, muscle tissue 49.5 ± 2.34 %, fat free mass 72.7 ± 5.23 kg and 53.2 ± 3.78 l of total body water. Conclusions: Elite military personnel presented high levels of fat free mass, muscle tissue and low levels of adipose tissue which favors the development of specialized military activities and decreases the risk of injury. The data collected here serve as a frame of reference for future studies.

Enfermedad renal crónica y COVID-19: la importancia de la hidratación / Chronic kidney disease and COVID-19: the importance of hydration

Resumen Como es bien sabido, desde el mes de diciembre se encendieron las alarmas por la aparición de la enfermedad COVID-19 (Coronavirus 2019) en China, la cual es causada por el virus SARS-CoV-2 y se ha expandido a nivel mundial. Entre los síntomas frecuentes encontramos fiebre, fatiga, mialgias, tos seca, anorexia, disnea y producción de esputo y síntomas menos comunes como cefalea, odinofagia, rinorrea y otra sintomatología diferente a la respiratoria, como síntomas gastrointestinales dados por náuseas y diarrea. La proteinuria en cualquier grado, la hematuria de cualquier grado, el aumento de la elevación de la creatinina en pacientes con creatinina basal elevada y la generación de AKI 2 y 3 son los directamente relacionados con la mortalidad intrahospitalaria desde el punto de vista renal, lo que hace que debamos estudiar más aun la enfermedad renal crónica, para poder tomar las medidas necesaria de prevención. En cuanto a la hidratación, se considera, por lo tanto, que si el paciente presenta buena diuresis, los 2 litros de excreción serían necesarios para eliminar los solutos no necesarios del cuerpo, considerando que esta cantidad se logra sumando también las pérdidas extrarrenales; entonces, si el paciente mantiene una función urinaria adecuada a pesar de su grado de insuficiencia renal, una ingesta de líquidos entre 2,5 y 3,5 litros logra las metas. Los pacientes con enfermedad renal crónica deben tomar las medidas de prevención, aún más por ser población de riesgo, recordando por lo tanto algunas, las cuales son la mejor estrategia para evitar la transmisión viral: lavado frecuente de manos, distanciamiento social, evitar contacto con personas infectadas o con sospecha de infección por el virus SARS-CoV-2, usar tapabocas, mantener higiene en su domicilio, lavar superficies o limpiarlas con sustancias a base de alcohol, y algo que no se puede olvidar: estamos aprendiendo del virus, y debemos mantenernos informados del comportamiento del mismo y de los cambios que este pueda generar en la población y en el comportamiento de la enfermedad, para así mismo tomar las medidas.

Abstract As is well known since December, alarms went off for the appearance of the COVID-19 disease (Coronavirus 2019) in China, which is caused by the SARS-CoV-2 virus and has spread worldwide. Frequent symptoms include fever, fatigue, myalgia, dry cough, anorexia, dyspnea and sputum production, and less common symptoms such as headache, odynophagia, rhinorrhea, and other symptoms other than breathing, such as gastrointestinal symptoms due to nausea and diarrhea. Proteinuria in any degree, hematuria of any degree, increased creatinine variation in a patient with elevated baseline creatinine, and the generation of AKI 2 and 3 are those directly related to in-hospital mortality from the renal point of view, which means that we must study chronic kidney disease even more, in order to take the necessary preventive measures. Regarding hydration, it is considered, therefore, that if the patient presents good diuresis, the 2 liters of excretion would be necessary to eliminate the unnecessary solutes from the body, considering that this amount is achieved by also adding extrarenal losses. Therefore, if the patient maintains adequate urinary function despite his degree of kidney failure, a fluid intake of between 2.5 and 3.5 liters achieves the goals, also taking into account. Patients with chronic kidney disease should take preventive measures, even more so as they are a risk population, therefore remembering some, which are the best strategy to avoid viral transmission: frequent hand washing, social distancing, avoiding contact with people infected or suspected of infection with the SARS-CoV-2 virus, wearing face masks, maintaining hygiene at home, washing surfaces or cleaning them with alcohol-based substances and something that cannot be forgotten, remember that we are learning from the virus and that we must keep us informed of the behavior of the same and of the changes that it may generate in the population and in the behavior of the disease, so as to take the measures.

The total fluids intake, volume of urine and hydration status among young adults from Hebei Province in spring / 中华预防医学杂志

Objectives@#To investigate the total fluids intake, volume of urine and hydration status among college students from Hebei Province in spring.@*Methods@#In March 2017, the subjects were recruited in a college in Baoding, Hebei Province. 156 students completed the investigation. Total drinking fluids was assessed by 7-day 24-hour fluid intake questionnaire, with a quantitative tool. The water from food was assessed by the duplicate portion method. The urine samples of 24-hour was collected for 3 consecutive days, and the volume, osmolality, pH and specific gravity of urine were measured. Hydration status was grouped to three types according to the urine osmolality (mOsm/kg), namely, optimal hydration (urine osmolality ≤500), middle hydration (500< urine osmolality ≥800) and dehydration (urine osmolality >800), and the differences among subjects in different genders and hydration statuses were compared.@*Results@#The age of all subjects was (19.8±1.1) years old, including 80 male students. The median amounts of total fluids intake, total drinking fluids, water from food and urine volume were 2 324, 1 135, 1 174 and 1 279 ml/d, respectively. The volume of urine among males was 1 272 ml/d, which was not significantly different from that of females (1 304 ml/d) (P>0.05). The osmolality and specific gravity of urine among males were 688 mOsm/kg and 1.017, which were higher than those of females (493 mOsm/kg, 1.014) (P<0.05). But the pH of males was 6.6±0.3, which was lower than that of females (6.7±0.3) (P<0.05). Only 37.2% (n=58) of college students were in optimal hydration status. The median of the amount of total drinking fluids among subjects in optimal hydration status was 301, 448 ml/d higher than that in middle hydration status and dehydration, respectively (P<0.05). The proportion of females in optimal hydration status was 51.3% (n=39), which was higher than that of males 23.8% (n=19) (P<0.05).@*Conclusion@#Large proportion of college students in Hebei had lower total drinking fluids than the recommended intake of China, and the volume of urine was equal to the amount of total drinking fluids among the college students. Only 37.2% of college students were in optimal hydration status, and the proportion of female college students in optimal hydration status was larger than that of males.

Hydration status and health / 中华预防医学杂志

Water is an important component of human body and plays a variety of important physiological roles. The intake and discharge of human water is in a dynamic equilibrium. Insufficient water intake will affect the hydration status of human body, which in turn affects cognition and health. Therefore, maintaining proper hydration status is of great importance for maintaining and promoting the health of the body. There were many indicators to evaluate the hydration status of body, including urine and blood plasma biomarkers. It is of great significance to evaluate the hydration status of body, keep the body in a suitable hydration status by replenishing water in time. The lack of drinking water in different populations in China is common, but it has not yet received enough attention and needs to carry out corresponding health education.

Assessment of fluid and nutritional status using bioelectrical impedance methods in acute kidney injury patients requiring continuous renal replacement therapy / 中华肾脏病杂志

Objective To investigate the predictive value of nutritional and fluid status measured by bioelectrical impedance methods for the prognosis of acute kidney injury (AKI) patients undergoing continuous renal replacement therapy (CRRT). Methods Patients with severe AKI received CRRT in the First Affiliated Hospital of Nanjing Medical University from September 2016 to September 2018 were enrolled, and divided into death group and survival group according to 28-day survival. Cox regression was used to analyze the association between 28-day survival and lean tissue index (LTI), fat tissue index (FTI), the ratio of extracellular water (ECW) and body cell mass (BCM) (ECW/BCM), and overhydration (OH), respectively. Results A total of 156 patients were included, including 101 males and 55 females. The age was (62.7 ± 15.4) years, with sequential organ failure assessment (SOFA) score of 9.9±3.9. The 28-day mortality rate was 46.2％. The pre-CRRT OH values in the 28-day survival group and death group were 2.95(1.80, 5.50) L and 4.20(2.95, 5.70) L(P=0.016), and ECW/BCM values were 1.00(0.76, 1.18) and 1.07(0.88, 1.25) (P=0.033), respectively. Univariate Cox regression analysis showed that pre-CRRT high OH values (HR=1.08, 95％CI 1.00-1.17, P=0.040) and high ECW/BCM values (HR=3.02, 95％CI 1.46-6.22, P=0.003) were associated with 28-day death. The changes of OH values (HR=0.83, 95％CI 0.72-0.95, P=0.008) and ECW/BCM values (HR=6.79, 95％CI 1.72-26.82, P=0.006) between pre - CRRT and the 7th day after CRRT initiation were significantly associated with 28-day mortality in patients who survived 7 days after CRRT initiation. After adjusting for age, gender, and SOFA scores, multivariate Cox regression analysis showed that the high OH value (HR=1.16, 95％CI 1.06-1.27, P=0.002) and the high ECW/BCM value (HR=2.80, 95％CI 1.30-6.06, P=0.003) before CRRT, the change of OH value (HR=0.82, 95％CI 0.72-0.95, P=0.008) and ECW/BCM value (HR=2.79, 95％CI 1.30-5.98, P=0.009) between the 7th day after CRRT initiation and pre-CRRT, were independently associated with 28-day death, while LTI (HR=0.93, 95％CI 0.86-1.02, P=0.113) and FTI (HR=0.98, 95％ CI 0.92-1.04, P=0.475) before CRRT were uncorrelated with 28-day death. Conclusions In bioelectrical impedance analysis, the high OH value and high ECW/BCM value before CRRT are associated with 28-day mortality in patients with AKI, while the nutritional indicators LTI and FTI before CRRT are not significantly related. The correction of fluid overload by CRRT within 7 days may reduce the risk of 28-day mortality.

Sub-morbid dehydration-associated glomerular hyperfiltration: An emerging reality?

BACKGROUND: Severe dehydration decreases renal perfusion. However, it is unclear whether sub-morbid dehydration affects kidney function similarly. Although there have been numerous animal and human studies that have suggested mild dehydration is associated with glomerular hyperfiltration, it has not been confirmed on a large-scale in the general population. Therefore, we aimed to identify the relationship between hydration status and kidney function. METHODS: We reviewed the data of 28,342 adults who participated in the Korea National Health and Nutrition Examination Surveys. Urine specific gravity unit (SGU) was the primary variable that indicated hydration status, and the estimated glomerular filtration rate (eGFR) was used as the primary outcome. RESULTS: Multivariate linear regression analysis showed urine SGU was positively associated with eGFR, which was J-shaped in the multivariate generalized additive model plot. In the penalized spline curve analysis, the odds ratio for high eGFR was steadily increased. Although increased urine SGU was associated with decreased blood pressure and pulse rate, it had no effect on increased fasting glucose and total cholesterol, suggesting conflicting cardio-metabolic dehydration effects. CONCLUSION: Dehydration, presumably sub-morbid in an ambulatory community-dwelling general population, is associated with higher kidney function. The clinical significance of sub-morbid dehydration-associated glomerular hyperfiltration needs further investigation.

Efficacy of triple diuretic treatment in continuous ambulatory peritoneal dialysis patients: A randomized controlled trial

BACKGROUND: The efficacy of combined diuretic treatment in patients undergoing continuous ambulatory peritoneal dialysis (CAPD) is not known. METHODS: In a single-center, double-blinded, randomized controlled trial, we randomly assigned 51 adult CAPD patients to receive furosemide 1,000 mg/day, hydrochlorothiazide 100 mg/day, and spironolactone 50 mg/day (triple diuretics [TD] group) or furosemide 1,000 mg/day plus placebo (single diuretic [SD] group) for 6 months. The primary outcome was the difference in daily urine output at the 3rd and 6th month of the study compared to baseline (ΔUO) between the SD and TD group. Secondary outcomes were urinary sodium (UNa) and potassium (UK) excretion and overhydration (OH) measured by bioimpedance at 3 and 6 months compared to baseline (ΔUNa, ΔUK, and ΔOH, respectively) and daily glucose exposure (g/day). RESULTS: Forty-three of 51 patients completed the 6-month trial. The ΔUO at 3 and 6 months was significantly higher in the TD group compared to the SD group (386.32 ± 733.92 mL/day vs. −136.25 ± 629.08 mL/day, P < 0.001, at 3 months; 311.58 ± 640.31 mL/day vs. 120.00 ± 624.07 mL/day, P < 0.001, at 6 months) but there was no significant difference in ΔUNa and ΔUK excretion. Hydration status was significantly better in the TD group (ΔOH 1.84 ± 2.27 L vs. 0.44 ± 1.62 L, P = 0.03, at 3 months; 1.49 ± 2.82 L vs. −0.48 ± 2.61 L, P = 0.02, at 6 months). There was no serious adverse event in this study. CONCLUSION: For end-stage renal disease patients on CAPD, the combination of furosemide, hydrochlorothiazide, and spironolactone results in higher urine output and better volume control compared to furosemide alone.

Role of common clinical indicators in volume assessments of peritoneal dialysis patients / 上海交通大学学报（医学版）

Objective: To investigate the role of common clinical indicators in volume assessments of peritoneal dialysis (PD) patients. Methods: Eligible PD patients in Renji Hospital, Shanghai Jiao Tong University School of Medicine from Nov. 2016 to Nov. 2017 were enrolled. Demographic data of patients were collected and clinical parameters were measured. Hydration status index overhydration (OH) was measured by bioimpedance spectroscopy, and the association between clinical indicators and OH was analyzed. Results: A total of 200 PD patients aged 56.3±13.8 years with median PD duration of 46.6 months were enrolled in the study. Among them, 117 (58.5%) patients were males and 42 (21.0%) patients were diabetic. 141 (70.5%) patients in the present study were overhydrated (OH>1.1 L). Compared to those with normal hydration, the overhydrated patients had higher blood pressure, more obvious edema and higher brain natriuretic peptide (BNP) level (P<0.05). In the overhydrated patients, 51 (36.2%) patients had normal blood pressure, 67 (47.5%) patients had no edema and 46 (32.6%) patients had BNP less than 100 pg/mL. In the normal hydrated patients, 20 (33.9%) patients had high blood pressure, 8 (13.6%) patients had edema and 1 (1.7%) patient had BNP higher than 400 pg/mL. Systolic pressure and BNP level were both correlated with OH positively (systolic pressure r=0.361, P=0.001; BNP r=0.615, P=0.000). The patients who had more obvious edema also had higher OH (P=0.000). Conclusion: Blood pressure, edema and BNP are closely associated with the hydration status, but only one of these clinical indicators can not accurately reflect the hydration status in all PD patients. Combination of different indicators may be useful in evaluation of hydration status in PD patients.

Hydration and pH of the Stratum Corneum in High-risk Newborns in the First 2 Weeks of Life

PURPOSE: The study was conducted to measure stratum corneum hydration (SCH) and pH (SCP) in high-risk newborns in the early postnatal period and to explore the features related to patterns of change in those parameters. METHODS: SCH and SCP were measured on the dorsal hand in 99 hospitalized newborns during the first 14 days of life and the results were analyzed using a general linear model. RESULTS: The mean hydration was 42.9% on day 1, which decreased to 34.6% by 2 weeks (F=15.61, p= < .001). An association was observed between SCH and prematurity (F=21.12, p < .001), as well as for their interaction (F=8.11, p < .001). The mean SCP was 6.2±0.3 on day 1, and decreased to 5.7±0.2 (F=95.75, p < .001), with no association with prematurity. After adjusting for birth weight, SCH was higher in newborns with vaginal delivery (F=9.07, p=.023) and who received phototherapy (F=11.81, p=.011). For SCP, only delivery type had a significant influence (F=6.40, p=.044). CONCLUSION: This study suggests that SCH is typically in the 30% range during the early postnatal period, and that an acid mantle on the SC surface is very unlikely to form; these findings could be applied to the nursing process for promoting skin integrity in high-risk neonates.

Relevância do estado de hidratação na interpretação de parâmetros nutricionais em diálise peritoneal / Relevance of hydration status on the interpretation of nutritional parameters in peritoneal dialysis

OBJETIVO: Identificar determinantes do estado de hidratação de pacientes em diálise peritoneal crônica, bem como investigar os efeitos da sobrecarga líquida sobre o estado nutricional. MÉTODOS: Foi feito estudo transversal, realizado em 2006, avaliando 27 pacientes em diálise peritoneal crônica, acompanhados no Hospital das Clínicas da Faculdade de Medicina de Botucatu (SP), quanto a parâmetros clínicos, dialíticos, laboratoriais, antropométricos e de bioimpedância elétrica. Para avaliar a influência de parâmetros sobre o estado de hidratação empregou-se modelo de regressão linear múltipla. A amostra foi estratificada quanto ao estado de hidratação pela relação entre água extracelular e água corporal total (0,47 para homens e 0,52 para mulheres), parâmetros obtidos por meio de bioimpedância elétrica. Comparações foram realizadas por análise de covariância, Mann-Whitney, Qui-quadrado ou teste exato de Fisher. Considerou-se significância estatística quando p≤0,05. RESULTADOS: Pacientes com maior volume urinário e em modalidade dialítica automatizada apresentaram melhor estado de hidratação. Pacientes com maior sobrecarga líquida, comparados àqueles com menor sobrecarga, apresentaram menor ângulo de fase (M=4,2, DP=0,9 vs M=5,7, DP=0,7º; p=0,006), menor albumina (M=3,06, DP=0,46 vs M=3,55, DP=0,52g/dL; p=0,05) e maior por cento prega cutânea tricipital (M=75,3, DP=36,9 vs M=92,1, DP=56,9 por cento; p=0,058), sem outras evidências antropométricas. CONCLUSÃO: Pode-se sugerir que os níveis reduzidos de albumina e ângulo de fase nos pacientes com maior sobrecarga líquida não estiveram relacionados a pior estado nutricional. Para o diagnóstico nutricional em vigência de sobrecarga líquida, deve-se considerar o conjunto de variáveis obtidas por diversos métodos, buscando relacioná-las e interpretá-las de maneira abrangente, possibilitando um diagnóstico nutricional fidedigno.

OBJECTIVE: This study identified determinants of the hydration status of chronic peritoneal dialysis patients and investigated the effects of fluid overload on their nutritional status. METHODS: A cross-sectional study was conducted in 2006 to evaluate 27 chronic peritoneal dialysis patients from the Dialysis Center of the Medical School Hospital of Botucatu (SP), considering clinical, dialytic, laboratory, anthropometric and bioimpedance parameters. A linear multiple regression model was used to evaluate the influence of these parameters on hydration status. The sample was stratified according to hydration status, given by the ratio between extracellular water and total body water (0.47 for males and 0.52 for females), obtained by bioelectrical impedance. Analysis of covariance, Mann-Whitney test, chi-square test, and Fisher's exact test were used for making comparisons. The significance level was set at 5 percent (p≤0.05). RESULTS: Patients with greater urine volume and receiving automatic dialysis presented better hydration status. Patients with higher fluid overload, compared with those with lower overload, presented lower phase angle (M=4.2, SD=0.9 vs. M=5.7, SD=0.7º; p=0.006), lower albumin levels (M=3.06, SD=0.46 vs. M=3.55, SD=0.52g/dL; p=0.05), and higher percentage of triceps skinfold thickness (M=75.3, SD=36.9 vs. M= 92.1, SD=56.9; p=0.058). No other anthropometric differences were observed. CONCLUSION: Low levels of albumin and phase angle in patients with higher fluid overload were not related to worse nutritional status. This result suggests that one must consider the set of variables obtained by many methods and relate and interpret them comprehensively in order to obtain a reliable nutritional diagnosis of patients with fluid overload.