Association between the estimated plasma volume status and chronic kidney disease: A cross-sectional study

The ongoing discourse examines the connection between chronic kidney disease (CKD) and the estimated status of plasma volume (ePVS). In this context, we aimed to assess how effectively ePVS can influence both the prevalence of CKD and the risk of mortality, including from cardiovascular disease (CVD), in CKD patients. This study utilized data from 25,142 eligible participants in the NHANES 1999 to 2018 cohort. We employed binary logistic regression, Cox proportional hazards models, restricted cubic splines (RCS), and threshold analyses to investigate the association between ePVS and CKD. Additionally, we examined the relationship between ePVS and mortality outcomes, including all-cause and cardiovascular mortality. Of the 25,142 study participants, the weighted prevalence of CKD was 18.04%. A nonlinear correlation was observed between ePVS and CKD prevalence. Furthermore, a positive correlation was identified between ePVS and CKD risk, with ePVS values exceeding the threshold of 3.198 associated with an increased risk of CKD development. Therefore, ROC curves indicated that ePVS demonstrated modest discrimination in forecasting CKD. Overall, the relationship between ePVS and both CKD occurrence and all-cause, CVD mortality among patients with CKD was found to be stable across the majority of analyzed subgroups (P for interactions > .05). ePVS levels increased with the prevalence of CKD. Furthermore, early detection and intervention for elevated ePVS levels in CKD patients may influence the progression of CKD and improve their prognosis.