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Excess epicardial fat mass misrepresented as cardiomegaly in dry‐weight assessment of a dialysis patient
Author(s) -
Kircelli Fatih,
Gunduz Mehmet,
Gungor Ozkan,
Ok Ercan
Publication year - 2012
Publication title -
hemodialysis international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.658
H-Index - 47
eISSN - 1542-4758
pISSN - 1492-7535
DOI - 10.1111/j.1542-4758.2011.00636.x
Subject(s) - medicine , dialysis , hemodialysis , epicardial fat , fat mass , cardiology , body weight , emergency medicine , intensive care medicine , adipose tissue
Obesity is a major health problem that has entered the nephrology community and is challenging our conventional management strategies. In this case report, we present a morbidly obese dialysis patient whom dry‐weight assessment was disturbed by excess epicardial fat mass due to obesity. This case suggests that problems related to obesity seem not to be limited to dealing with obesity‐associated kidney injury, chronic kidney disease and mortality, but also other concepts in nephrology such that, as described, excess epicardial fat mass related to morbid obesity in this patient erroneously suggested a high cardiothoracic index, and misled patient management. Interpretation of chest X ‐ray in dry‐weight assessment should take into account the patient's body weight especially in obese cases and alternative diagnostic methods for correct determination of fluid status are highly needed.