ECHOGRAPHY OF THE INFERIOR VENA CAVA FOR INTRAVASCULAR FLUID VOLUME ASSESSMENT IN NORMOTENSIVE AND HYPERTENSIVE HAEMODIALYZED PATIENTS

Abstract

SUMMARY AND CONCLUSION

Fluid balance is an integral componant of haemodialysis treatment to prevent intradialytic morbidity and long-term cardiovascular complications. Fluid removal is usually done by ultrafiltration to achieve the dry weight. Several methods have been suggested to determine fluid status of the patients. Clinical status and chest x-ray are not sensitive '• enough while invasively measured CVP is not routinely available and

measurement of ANP and c-GMP are controversial. The sonographic determination of IVC diameter has been proposed as a good non-invasive method for estimating intra-vascular volume.

This study was designed to assess the intravascular fluid volume by measurement of IVC diameter by ultrasound in both normotensive and hypertensive dialyzed patients and to determine whether control of extra­ cellular fluid volume by ultrafiltration as assessed by change of body weight and IVC diameter after dialysis is correlated with blood pressure control and whether such normotension achievement is associated with improvement of Kt/V and haemoglobin levels as indicators of dialysis adequacy.

Fifty patients were studied; 25 normotensives (group I) and 25 hypertensives (group II). All patients were subjected to the following: history, clinical examenation, sampling for blood urea during dialysis, sampling for creatinine and haemoglobin levels predialysis, and IVC diameter measurement by ultrasound, predialysis and 2-hours post dialysis.