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Fluid status evaluation by inferior vena cava diameter and bioimpedance spectroscopy in pediatric chronic hemodialysis.
BMC Nephrol. 2017 12 28; 18(1):373.BN

Abstract

BACKGROUND

Evaluation of patient's dry weight remains challenging in chronic hemodialysis (HD) especially in children. Inferior Vena Cava (IVC) measurement was reported useful to assess fluid overload both in adults and children.

METHODS

We performed a monocentric prospective study to evaluate the relation between predialytic IVC diameter measurements and hydration status evaluated by physicians and bioimpedance spectroscopy (BIS) and between IVC measurements and persistent hypertension.

RESULTS

Forty-eight HD sessions in 16 patients were analyzed. According to physicians, patients were overhydrated in 84.5% of dialysis sessions, 20.8% according to BIS, and 0%, 4.1% and 20.8% according to IVC inspiratory, expiratory and collapsibility index reference curves respectively. There was no correlation between relative overhydration evaluated by BIS and IVC measurements z-scores (p = 0.20). Patients whose blood pressure normalized after HD had a more dilated maximal IVC diameter before dialysis session than patients with persistent hypertension (median - 0.07SD [-0.8; 0.88] versus -1.61SD [-2.18; -0.74] (p = 0.03)) with an optimal cut-off of -0.5 SD.

CONCLUSIONS

In our study, IVC measurement is not reliable to assess fluid overload in children on HD and was not correlated with extracellular fluid volume assessed by BIS measurements. However, IVC measurements might be of interest in differentiating volume-dependant hypertension from volume-independant hypertension.

Authors+Show Affiliations

Department of Paediatric Nephrology and Hemodialysis, Hôpital Robert Debré, APHP, 48 boulevard Sérurier 75019, 19, Paris Cedex, France.Department of Paediatric Nephrology and Hemodialysis, Hôpital Robert Debré, APHP, 48 boulevard Sérurier 75019, 19, Paris Cedex, France.Department of Paediatric Nephrology and Hemodialysis, Hôpital Robert Debré, APHP, 48 boulevard Sérurier 75019, 19, Paris Cedex, France.Department of Paediatric Nephrology and Hemodialysis, Hôpital Robert Debré, APHP, 48 boulevard Sérurier 75019, 19, Paris Cedex, France.Department of Paediatric Nephrology and Hemodialysis, Hôpital Robert Debré, APHP, 48 boulevard Sérurier 75019, 19, Paris Cedex, France.Department of Paediatric Nephrology and Hemodialysis, Hôpital Robert Debré, APHP, 48 boulevard Sérurier 75019, 19, Paris Cedex, France.Department of Paediatric Nephrology and Hemodialysis, Hôpital Robert Debré, APHP, 48 boulevard Sérurier 75019, 19, Paris Cedex, France. julien.hogan@hotmail.fr.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

29282003

Citation

Torterüe, Xavier, et al. "Fluid Status Evaluation By Inferior Vena Cava Diameter and Bioimpedance Spectroscopy in Pediatric Chronic Hemodialysis." BMC Nephrology, vol. 18, no. 1, 2017, p. 373.
Torterüe X, Dehoux L, Macher MA, et al. Fluid status evaluation by inferior vena cava diameter and bioimpedance spectroscopy in pediatric chronic hemodialysis. BMC Nephrol. 2017;18(1):373.
Torterüe, X., Dehoux, L., Macher, M. A., Niel, O., Kwon, T., Deschênes, G., & Hogan, J. (2017). Fluid status evaluation by inferior vena cava diameter and bioimpedance spectroscopy in pediatric chronic hemodialysis. BMC Nephrology, 18(1), 373. https://doi.org/10.1186/s12882-017-0793-1
Torterüe X, et al. Fluid Status Evaluation By Inferior Vena Cava Diameter and Bioimpedance Spectroscopy in Pediatric Chronic Hemodialysis. BMC Nephrol. 2017 12 28;18(1):373. PubMed PMID: 29282003.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Fluid status evaluation by inferior vena cava diameter and bioimpedance spectroscopy in pediatric chronic hemodialysis. AU - Torterüe,Xavier, AU - Dehoux,Laurène, AU - Macher,Marie-Alice, AU - Niel,Olivier, AU - Kwon,Thérésa, AU - Deschênes,Georges, AU - Hogan,Julien, Y1 - 2017/12/28/ PY - 2017/06/27/received PY - 2017/12/12/accepted PY - 2017/12/29/entrez PY - 2017/12/29/pubmed PY - 2018/8/28/medline KW - Bioimpedance KW - Blood pressure KW - Children KW - Dry weight KW - Hemodialysis KW - Inferior vena cava SP - 373 EP - 373 JF - BMC nephrology JO - BMC Nephrol VL - 18 IS - 1 N2 - BACKGROUND: Evaluation of patient's dry weight remains challenging in chronic hemodialysis (HD) especially in children. Inferior Vena Cava (IVC) measurement was reported useful to assess fluid overload both in adults and children. METHODS: We performed a monocentric prospective study to evaluate the relation between predialytic IVC diameter measurements and hydration status evaluated by physicians and bioimpedance spectroscopy (BIS) and between IVC measurements and persistent hypertension. RESULTS: Forty-eight HD sessions in 16 patients were analyzed. According to physicians, patients were overhydrated in 84.5% of dialysis sessions, 20.8% according to BIS, and 0%, 4.1% and 20.8% according to IVC inspiratory, expiratory and collapsibility index reference curves respectively. There was no correlation between relative overhydration evaluated by BIS and IVC measurements z-scores (p = 0.20). Patients whose blood pressure normalized after HD had a more dilated maximal IVC diameter before dialysis session than patients with persistent hypertension (median - 0.07SD [-0.8; 0.88] versus -1.61SD [-2.18; -0.74] (p = 0.03)) with an optimal cut-off of -0.5 SD. CONCLUSIONS: In our study, IVC measurement is not reliable to assess fluid overload in children on HD and was not correlated with extracellular fluid volume assessed by BIS measurements. However, IVC measurements might be of interest in differentiating volume-dependant hypertension from volume-independant hypertension. SN - 1471-2369 UR - https://www.unboundmedicine.com/medline/citation/29282003/Fluid_status_evaluation_by_inferior_vena_cava_diameter_and_bioimpedance_spectroscopy_in_pediatric_chronic_hemodialysis_ L2 - https://www.biomedcentral.com/1471-2369/18/373 DB - PRIME DP - Unbound Medicine ER -