NPPB and left ventricular hypertrophy: Fluid overload measured by bioimpedance is evident in very early CKD86 and has been associated with diastolic dysfunction87 and left ventricular hypertrophy on echocardiography.88 Identifying this subclinical diastolic dysfunction is challenging in CKD because NTpro-BNP is an imperfect diagnostic marker in those with decreased kidney function.89 Bioimpedance techniques may, therefore, represent an attractive tool for identification of patients with CKD who might benefit from screening echocardiographic assessments.