# Unveiling the Impact of Total Body Fluid Dynamics on Chronic Rhinosinusitis With Sinonasal Polyposis

## TL;DR

This study explores how body fluid balance might influence the development of nasal polyps in chronic sinusitis patients.

## Contribution

It introduces a novel analysis of total body fluid dynamics and renal markers in sinonasal polyposis.

## Key findings

- Elevated serum creatinine levels were significantly associated with sinonasal polyposis.
- A regression model showed good discriminative ability (AUC = 0.803) for predicting polyposis based on creatinine levels.
- Excess body water showed a non-significant trend toward increased polyposis risk.

## Abstract

Background: This study investigated the role of total body fluid dynamics in developing polyposis in patients with chronic rhinosinusitis. There is a significant gap in our understanding of body fluid dynamics in the pathogenesis of sinonasal polyposis. This preliminary research will be sensitized to explore hidden facts in this field further.

Methods: In this cross-sectional study at a tertiary care hospital, 60 participants were enrolled, comprising 30 patients diagnosed with sinonasal polyposis and 30 controls without polyps. The measured parameters included total body water, excess body water, serum osmolality, albumin, creatinine, sodium, eosinophil count, arterial pH, and hematocrit. The t-test/Mann-Whitney U test and chi-square test were used for continuous and categorical variable analysis, respectively. Univariate and multivariate logistic regression was done to identify potential predictors, and model performance was evaluated using the receiver operating characteristic (ROC) curves, with an optimal classification cut-off of 0.5 for the area under the curve (AUC).

Results: The mean age of cases was 34.03 ± 12.76 years, and that of controls was 34.77 ± 12.06 years. Amongst cases, 60% were males and 40% were females, while the control group had an equal distribution of males and females. The mean total body water level in patients with sinonasal polyposis was slightly higher than in those without polyps (34.42 ± 5.26 l vs. 32.38 ± 5.86 l). Moreover, the likelihood of developing sinonasal polyposis was twice as high in patients with excess body water compared to those without, as suggested by an adjusted odds ratio (OR) of 2.08. However, this association was not statistically significant (95% CI: 0.83-5.19, p = 0.116). Patients with polyposis also showed higher serum creatinine levels (0.94 mg/dL) than controls (0.80 mg/dL, p = 0.002). Univariate logistic regression indicated that a 1 mg/dL increase in serum creatinine level was associated with a 2.4-fold increase in the likelihood of polyposis (OR = 2.42, 95% CI: 1.30-4.50, p = 0.005). Multivariate analysis confirmed the significance of serum creatinine level (adjusted OR = 3.36, 95% CI: 1.42-7.97, p = 0.006), with an AUC of 0.803, demonstrating good discriminative ability. The model's accuracy, sensitivity, and specificity were 66.7%, 73.3%, and 60%, respectively.

Conclusions: Significantly elevated serum creatinine levels in patients with sinonasal polyposis may suggest a potential link with renal function or fluid regulation, warranting further research in larger cohorts to clarify this relationship. The regression model indicated a positive correlation between excess body water and the development of polyposis, with a weaker trend observed for other parameters. However, due to insufficient evidence, further research involving larger sample sizes across diverse geographic regions is recommended to validate their roles in the pathogenesis of sinonasal polyps.