Document Detail


Evaluation of markers to estimate volume status in hemodialysis patients: atrial natriuretic peptide, inferior vena cava diameter, blood volume changes and filtration coefficients of microvasculature.
MedLine Citation:
PMID:  17381534     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Relationships among five markers of volume status - cardio-thoracic ratio (CTR), atrial natriuretic peptide (ANP), inferior vena cava diameter at quiet expiration (IVCe), blood volume change (Delta BV/TUF) during ultrafiltration and filtration coefficients of microvasculature (Lpst) - were investigated. Fifty stable hemodialysis patients were enrolled. The CTR was measured before hemodialysis (HD), and ultrasonic measurement of IVCe and sample collection for ANP were performed shortly after HD. Lpst and Delta BV/TUF were calculated using a CRIT-LINE monitor. Overhydrated patients determined by each marker (OVERctr, OVERivc, OVERanp, OVERlp and OVERbv) were compared. The agreement of volume status determined by each marker was assessed by kappa value, and the sensitivity and specificity of each marker to distinguish overhydrated patients were analyzed by a receiver-operating characteristic (ROC) curve. IVCe, ANP, Delta BV/TUF and Lpst, significantly correlated with each other. The correlation coefficients of Lpst with IVCe, ANP and Delta BV/TUF were higher than the others. The kappa value between ANP and Lpst was the highest. OVERanp was the highest, then OVERlp, OVERivc and OVERbv, in this order. The OVERlp and OVERivc patients were completely included in OVERanp. All patients, except one OVERbv patient, were included in OVERlp. The relatively high distinguishing ability of Lpst was demonstrated by ROC analysis. These results suggest that the determination of overhydration solely by ANP was an overestimation and by Delta BV/TUF was an underestimation. The relatively high correlation coefficients of Lpst with other markers, as well as its distinguishing ability, suggest that Lpst fluctuates in close relation to other markers.
Authors:
Masatomo Yashiro; Tadashi Kamata; Noriko Yamadori; Mayumi Tomita; Eri Muso
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Therapeutic apheresis and dialysis : official peer-reviewed journal of the International Society for Apheresis, the Japanese Society for Apheresis, the Japanese Society for Dialysis Therapy     Volume:  11     ISSN:  1744-9979     ISO Abbreviation:  Ther Apher Dial     Publication Date:  2007 Apr 
Date Detail:
Created Date:  2007-03-26     Completed Date:  2007-11-13     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101181252     Medline TA:  Ther Apher Dial     Country:  Australia    
Other Details:
Languages:  eng     Pagination:  131-7     Citation Subset:  IM    
Affiliation:
Division of Nephrology, Kyoto City Hospital, Kyoto, Japan. yashiro@pearl.ocn.ne.jp
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aged, 80 and over
Atrial Natriuretic Factor / analysis*
Biological Markers
Blood Volume*
Body Weight
Echocardiography
Extracellular Fluid
Female
Filtration*
Heart / anatomy & histology*,  radiography
Humans
Male
Middle Aged
ROC Curve
Renal Dialysis* / methods
Sensitivity and Specificity
Thorax / anatomy & histology
Vena Cava, Inferior / anatomy & histology*,  ultrasonography
Chemical
Reg. No./Substance:
0/Biological Markers; 85637-73-6/Atrial Natriuretic Factor

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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