Ultrasonographic measurement of inferior vena cava diameter as an index of ultrafiltration adequacy in dialysed uraemic patients

Abstract EN

This study was designed to assess the adequacy of uhrafiltration during dialysis by ultrasonographic measurement of inferior vena cava (IVC) diameter in both normotensive and hypertensive dialysed uraemic patients and to determine whether control of extracellular fluid volume by ultrafiltration is correlated with blood pressure control Fifty patients were studied, 25 normotensives (group /> and 25 hypertensives (group II).

The patients of the later group were followed for 8 month with gradual increase in uhrafiltration and decrease in the dose and the number of anti-hypertensive agents In addition to thorough clinical examination including blood pressue body weigth sampling for estimation of blood urea pre and post dialysis and calculation of Kt/V which is defined as the rate of urea removal normalized for body surface, serum creatinine, haemoglobin concentration and ultrasonographic measurement of IVC diameter predialysis and 2- hours post dialysis were done Results showed that body weight and IVC diameter were significantly (p<0001) higher in group II compared with group 1 and were significantly lower at post dialysis time compared to predialysis time in both groups while haemoglobin levels and Kt/V showed insignificant changes.

At the end of the follow up period for group II patients 10 patients (group Ha) nor muter.snes with idtrafiltration only without antihyperlenstve drugs.

9 patients (group lib) became normotensives with ultrafiltration plus antihypertensive drugs and 6 patients (group He) remained hypertensives despite uhrafiltration and hypertensive drugs A significant negative correlations were i>bserved between the duratiim of dialysis in years and both the systolic and diastolic blood pressures, body weight and Kt/V and IVC diameter and Kt/V.

In conclusion, ultrasonographic measurement of IVC diameter assessment of adequacy of ultrafiltratiim to control hypertension in dialysis patients Thus avoiding the side effects of antihypertensive drugs and decrease the cost.

Routine sonographic assessment of IVC diameter in dialysis patients is recommended.