The utility and limitation of inferior vena cava diameter as a dry weight marker.
作者信息
Shibata Eriko, Nagai Kojiro, Ueda Sayo, Ono Hiroyuki, Nishimura Kenji, Inagaki Taizo, Minato Masanori, Kishi Fumi, Tamaki Masanori, Murakami Taichi, Kishi Seiji, Abe Hideharu, Yokota Narushi, Minakuchi Jun, Doi Toshio
机构信息
Department of Nephrology, Institute of Biomedical Sciences, Tokushima University Graduate School, Japan.
Department of Kidney Disease (Dialysis & Transplantation), Kawashima Hospital, Tokushima, Japan.
出版信息
J Med Invest. 2019;66(1.2):172-177. doi: 10.2152/jmi.66.172.
BACKGROUND
IVC diameter on expiration (IVCdexp) is measured by echocardiography routinely. It is used to estimate volume status and designated as a definitive marker for determining dry weight (DW) in patients undergoing hemodialysis (HD).
METHODS
A cross-sectional study. Outpatients (n = 107), and inpatients (n = 35) undergoing HD were enrolled. IVCdexp was measured on non-dialysis days in outpatients and dialysis days before and after the dialysis session in inpatients. In outpatients, the relationship of IVCdexp with echocardiography findings and clinical characteristics was analyzed. IVCdexp was compared with the other DW markers as a predictive factor for intradialytic hypotension. In inpatients, IVCdexp was analyzed by dividing inpatients with or without fluid in extravascular space.
RESULTS
IVCdexp ranged from 5.4 to 16.9 mm in outpatients who had optimal DW. IVCdexp could reflect on volume status, but not predictive for intradialytic hypotension and not suggestive of fluid in extravascular space.
CONCLUSIONS
IVCdexp was a rough marker to estimate volume status and only useful in suggesting apparent hypervolemia or hypovolemia. We should know that the IVCdexp value is affected by a lotof factors and not a definitive marker for estimating practical DW. J. Med. Invest. 66 : 172-177, February, 2019.
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