Abstract
Recently, measurements of the inferior vena cava diameter have been found to be useful in the assessment of the precise dry weight in hemodialysis (HD) patients. We measured the maximal diameter of the IVC at expiration (IVC-E), the minimal diameter at inspiration (IVC-I) and the collapsibility index (CI:(IVC-E-IVC-I)/IVC-E) in 50 patients with chronic renal failure undergoing hemodialysis who had no clinical signs of cardiac or respiratory failure. In addition, serum levels of h-ANP were measured.
No significant correlation was found between the percent changes in body weight (ΔBW%: (pre HD BW-post HD BW)/post HD BW) and percent changes in h-ANP (Δh-ANP%: (pre HD h-ANP-post HD h-ANP)/post HD h-ANP).
The mean IVC-E before HD was significantly correlated with the mean h-ANP level before HD (r=0.57, p<0.001), but no significant correlation was found between the mean IVC-E and the mean h-ANP level after HD.
ΔBW% were significantly correlated with the percent changes in IVC-E before and after hemodialysis (r=0.75, p<0.001).
In analysis limited to diabetic patients (n=15), each study concerned with CI and IVC-E showed results identical to those found in overall cases. These findings suggest that evaluation of IVC-E by ultrasonic procedures is a reliable indicator to determine the dry weight in hemodialyzed patients including diabetic patients, particularly in those with excess dehydration.
