Document Detail

A critical evaluation of ultrasound measurement of inferior vena cava diameter in assessing dry weight in normotensive and hypertensive hemodialysis patients.
MedLine Citation:
PMID:  9328358     Owner:  NLM     Status:  MEDLINE    
The utility of measurement of the inferior vena cava diameter (IVCD) with ultrasound for the assessment of fluid status and posthemodialysis dry weight was studied in 35 hemodialysis (HD) patients, 17 with and 18 without hypertension. In 17 patients (group A), IVCD was measured before and 35 to 40 minutes after HD, pre-HD blood volume (BV) was measured with radiolabeled albumin and post-HD BV was calculated from the change in hematocrit. In 18 patients (group B), IVCD was measured repeatedly during HD and 2 hours after HD. Changes in BV were recorded by monitoring of the hematocrit "on line." Body weight, blood pressure (BP), BV, and IVCD decreased in the entire population. In group A, BV was significantly larger in the hypertensive patients than in the normotensive patients, and it was correlated with the mean BP before and after HD. In the whole population, IVCD was larger in the hypertensive than in the normotensive patients before and after HD. These results confirm that extracellular fluid overload plays an important role in the pathogenesis of dialysis-associated hypertension. In group B, BV and IVCD decreased in parallel during HD and increased during 2 hours after HD due to refilling of the intravascular space, indicating that changes in IVCD reflect changes in BV. In 8 patients studied twice, IVCD increased much more after a 3-hour HD session than after a 6-hour session. At the end of HD, several patients had IVCD below the reference range but IVCD increased during the following 1 to 2 hours, in some patients to values above the reference range. IVCD measured at the end or shortly after HD may therefore be misleading in assessing dry weight.
K S Katzarski; J Nisell; I Randmaa; A Danielsson; U Freyschuss; J Bergström
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  American journal of kidney diseases : the official journal of the National Kidney Foundation     Volume:  30     ISSN:  0272-6386     ISO Abbreviation:  Am. J. Kidney Dis.     Publication Date:  1997 Oct 
Date Detail:
Created Date:  1997-10-23     Completed Date:  1997-10-23     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  8110075     Medline TA:  Am J Kidney Dis     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  459-65     Citation Subset:  IM    
Department of Clinical Science, Huddinge University Hospital, Karolinska Institute, Stockholm, Sweden.
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MeSH Terms
Blood Volume
Body Weight
Case-Control Studies
Extracellular Space
Hypertension, Renal / etiology,  ultrasonography*
Kidney Failure, Chronic / complications,  therapy*,  ultrasonography
Middle Aged
Reference Values
Renal Dialysis*
Time Factors
Vena Cava, Inferior / ultrasonography*
Water-Electrolyte Imbalance / diagnosis,  etiology
Comment In:
Am J Kidney Dis. 1997 Oct;30(4):577-8   [PMID:  9328376 ]

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

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