A CRITICAL-EVALUATION OF ULTRASOUND MEASUREMENT OF INFERIOR VENA-CAVADIAMETER IN ASSESSING DRY-WEIGHT IN NORMOTENSIVE AND HYPERTENSIVE HEMODIALYSIS-PATIENTS

Citation
Ks. Katzarski et al., A CRITICAL-EVALUATION OF ULTRASOUND MEASUREMENT OF INFERIOR VENA-CAVADIAMETER IN ASSESSING DRY-WEIGHT IN NORMOTENSIVE AND HYPERTENSIVE HEMODIALYSIS-PATIENTS, American journal of kidney diseases, 30(4), 1997, pp. 459-465
Citations number
19
Language
INGLESE
art.tipo
Article
Categorie Soggetti
Urology & Nephrology
ISSN journal
0272-6386
Volume
30
Issue
4
Year of publication
1997
Pages
459 - 465
Database
ISI
SICI code
0272-6386(1997)30:4<459:ACOUMO>2.0.ZU;2-C
Abstract
The utility of measurement of the inferior vena cava diameter (IVCD) w ith ultrasound for the assessment of fluid status and posthemodialysis dry weight was studied in 35 hemodialysis (HD) patients, 17 with and 18 without hypertension, In 17 patients (group A), IVCD was measured b efore and 35 to 40 minutes after HD, pre-ND blood volume (BV) was meas ured with radiolabeled albumin and post-HD BV was calculated from the change in hematocrit, In 18 patients (group B), IVCD was measured repe atedly during HD and 2 hours after HD. Changes in BV were recorded by monitoring of the hematocrit ''on line.'' Body weight, blood pressure (BP), BV, and IVCD decreased in the entire population, In group A, BV was significantly larger in the hypertensive patients than in the norm otensive patients, and it was correlated with the mean BP before and a fter HD. In the whole population, IVCD was larger in the hypertensive than in the normotensive patients before and after HD, These results c onfirm that extracellular fluid overload plays an important role in th e pathogenesis of dialysis-associated hypertension, In group B, BV and IVCD decreased in parallel during HD and increased during 2 hours aft er HD due to refilling of the intravascular space, indicating that cha nges in IVCD reflect changes in BV, In 8 patients studied twice, IVCD increased much more after a 3-hour HD session than after a 6-hour sess ion, At the end of HD, several patients had IVCD below the reference r ange but IVCD increased during the following 1 to 2 hours, in some pat ients to values above the reference range, IVCD measured at the end or shortly after HD may therefore be misleading in assessing dry weight. (C) 1997 by the National Kidney Foundation, Inc.