{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T03:45:07Z","timestamp":1791949507726,"version":"4.3.4"},"reference-count":61,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T00:00:00Z","timestamp":1791849600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T00:00:00Z","timestamp":1791849600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Seminars in Dialysis"],"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Chronic fluid imbalance in maintenance hemodialysis can increase cardiovascular risk through activation of the renin\u2013angiotensin\u2013aldosterone pathway. This study compared the endocrine and hemodynamic effects of three fluid management strategies in adults receiving maintenance hemodialysis in a prospective two\u2010center observational cohort study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Six hundred patients were assigned to fluid management by clinical assessment, bioimpedance\u2010guided monitoring, or absolute blood volume monitoring, with 200 patients in each group. Plasma renin activity, angiotensin II, aldosterone, systolic and diastolic blood pressure, and arterial stiffness were measured at baseline and Weeks 6 and 12. Between\u2010group and over\u2010time differences were analyzed using adjusted longitudinal and covariance\u2010based models. Additional analyses examined variation by age, fluid status pattern, and sodium self\u2010management.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>By Week 12, plasma renin activity, angiotensin II, and aldosterone increased in the clinical assessment group showed smaller increases or minimal change in the bioimpedance\u2010guided group and declined in the absolute blood volume monitoring group. The absolute blood volume monitoring group also showed the greatest improvement in blood pressure and arterial stiffness over follow\u2010up. In addition, this group had the lowest frequency of intradialytic hypotension and the strongest improvement in patient self\u2010management measures.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Absolute blood volume monitoring was associated with greater short\u2010term suppression of endocrine activation and better hemodynamic outcomes than clinical assessment or bioimpedance\u2010guided monitoring during the 12\u2010week follow\u2010up period.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/sdi.70047","type":"journal-article","created":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T02:51:01Z","timestamp":1791946261000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["The Effects of Fluid Management Approaches on Renin\u2013Angiotensin\u2013Aldosterone System Activity and Blood Pressure Control in Patients on Dialysis"],"prefix":"10.1111","author":[{"given":"Feng","family":"Mingming","sequence":"first","affiliation":[{"name":"Department of Liver Surgery West China Hospital\/West China School of Nursing, Sichuan University  Chengdu Sichuan China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-3675-8646","authenticated-orcid":false,"given":"Yu","family":"Yan","sequence":"additional","affiliation":[{"name":"Haemodialysis Center, Department of Nephrology West China Hospital\/West China School of Nursing, Sichuan University  Chengdu Sichuan China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yang","family":"Ting","sequence":"additional","affiliation":[{"name":"Operating Room Department West China Hospital, Sichuan University  Chengdu Sichuan China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,10,13]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.2147\/IJNRD.S440990"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1159\/000530816"},{"key":"e_1_2_8_4_1","first-page":"393","volume-title":"Handbook of Dialysis Therapy","author":"Van Buren P. 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