Saha Anshuman, Anila A P, Pavan K V, Iyengar Arpana, Vasudevan Anil
Department of Pediatric Nephrology, St John's Medical College, Bengaluru, India.
Department of Pediatric Nephrology, Institute of Kidney Diseases and Research Centre and Gujarat University of Transplantation Sciences, Ahmedabad, Gujarat, India.
Indian Pediatr. 2025 Aug 6. doi: 10.1007/s13312-025-00154-x.
To correlate the inferior vena cava/aorta diameter (IVC/Ao index) in children with nephrotic syndrome with clinical indicators of volume status, and to compare the IVC/Ao index between children in relapse and in remission.
This prospective longitudinal study included children aged 2-18 years presenting with relapsed nephrotic syndrome. Low intravascular volume status was diagnosed if two of the three criteria (tachycardia, hypotension, prolonged capillary filling time) were present. Sonographic measurements of the IVC and aorta diameter were obtained by a single observer at recruitment and after achieving remission.
One hundred and three children (73 boys) with a median (Q1, Q3) age 72 (24, 216) months were recruited. 26 (25%) children had low intravascular volume at recruitment. The mean (SD) IVC/Ao index was lower in low volume status compared to normal volume status [0.74 (0.2) vs 0.83 (0.1); P = 0.090]. The correlation between IVC/Ao index and heart rate (r = -0.29, P = 0.003) and mean arterial pressure (r = 0.23, P = 0.018) was weak. IVC/Ao index was not an independent predictor of volume status (OR = 0.04, P = 0.331). The mean (SD) IVC/Ao index increased significantly from when in relapse to remission [0.94 (0.1) vs 1.05 (0.2), respectively; P = 0.001].
The IVC/Ao index was lower in relapse than in remission, and did not predict low intravascular volume status independently.
将肾病综合征患儿的下腔静脉/主动脉直径（IVC/Ao指数）与容量状态的临床指标相关联，并比较复发期和缓解期患儿的IVC/Ao指数。
这项前瞻性纵向研究纳入了2至18岁复发肾病综合征的患儿。如果出现三项标准（心动过速、低血压、毛细血管充盈时间延长）中的两项，则诊断为低血管内容量状态。在招募时和达到缓解后，由一名观察者对IVC和主动脉直径进行超声测量。
招募了103名儿童（73名男孩），中位（Q1，Q3）年龄为72（24，216）个月。26名（25%）儿童在招募时血管内容量较低。与正常容量状态相比，低容量状态下的平均（SD）IVC/Ao指数较低[0.74（0.2）对0.83（0.1）；P = 0.090]。IVC/Ao指数与心率（r = -0.29，P = 0.003）和平均动脉压（r = 0.23，P = 0.018）之间的相关性较弱。IVC/Ao指数不是容量状态的独立预测指标（OR = 0.04，P = 0.331）。从复发到缓解，平均（SD）IVC/Ao指数显著增加[分别为0.94（0.1）对1.05（0.2）；P = 0.001]。
复发期的IVC/Ao指数低于缓解期，且不能独立预测低血管内容量状态。
