Conclusions Volume overload exhibits a strong association with CKD progression and CVD morbidity or mortality in patients with stage 3 to 5 CKD. In animal models of CKD, salt-induced fluid retention results in renal and cardiovascular damage, which is ameliorated by diuretics. Therefore, our findings suggest that volume overload is an important mechanism contributing to the adverse outcomes observed in CKD and requires appropriate management. Further research is warranted to clarify whether the correction of volume overload should be one of the main targets to achieve better outcomes in patients with CKD