The role of bioelectrical impedance analysis, NT-ProBNP and inferior vena cava sonography in the assessment of body fluid volume in children with nephrotic syndrome

Pendahuluan. Dalam praktek klinis, status cairan pada pasien hemodialisis (HD) sangat berkaitan dengan berat kering. Penentuan berat kering yang dilakukan secara klinis tidak akurat sehingga diajukan berbagai metode untuk menilai berat kering secara noninvasif diantaranya yaitu pemeriksaan analisis bioimpedansi dan pemeriksaan indeks kolapsibilitas vena kava inferior. Penelitian ini dilakukan untuk mengetahui korelasi antara pengukuran indeks kolapsibilitas diameter vena kava inferior dan pemeriksaan analisis biompedansi. Sehingga, dapat diketahui peran pemeriksaan indeks kolapsibilitas vena kava inferior dalam mengevaluasi berat kering pada pasien dialisis.Metode. Studi potong lintang dilakukan di unit HD Rumah Sakit dr. Cipto Mangunkusumo (RSCM) Jakarta pada bulan Juni 2011 dengan metode pengambilan sampel konsekutif. Berat kering dinilai dengan analisis bioimpedansi dan pemeriksaan indeks kolapsibilitas vena kava inferior dinilai dengan menggunakan USG.Hasil. Dari 30 subyek penelitian dengan rentang usia 24-69 tahun dan rerata 52 tahun , 18 (60%) subyek di antaranya mengalami kelebihan cairan menurut analisis bioimpedansi, sedangkan menurut pemeriksaan indeks kolapsibilitas vena kava inferior didapatkan 21 orang kelebihan cairan. . Terdapat korelasi negatif sedang antara pemeriksaan indeks kolapsibilitas diameter vena kava inferior dengan analisis bioimpedansi (r= -0,597, p<0,0001). Nilai sensitivitas dan spesifisitas untuk pemeriksaan indeks kolapsibilitas diameter vena kava inferior yaitu 94,4% dan 66,7%. Pada kedua operator USG didapatkan nilai κ (kappa) sebesar 0,92, artinya memiliki kesesuaian yang sangat kuat.Simpulan. Pemeriksaan indeks kolapsibilitas diameter vena kava inferior mempunyai peran sebagai alat skrining yang cukup baik dalam menilai berat kering pada pasien hemodialisis.Kata kunci: analisa bioimpedansi, berat kering, hemodialisis, indekskolapsibilitas vena kava inferior, korelasiDiagnostic Value and the Role of Inferior Vena Cava Diameter Collapsibility Index to Evaluate Dry Weight in Hemodialysis PatientsIntroduction. In daily clinical practice, fluid status in Hemodialysis (HD) patients is well correlated with dry weight calculation. Dry weight calculation is commonly practiced by clinical observation, which is not accurate. Because of these, few methods has been suggested to calculate the dry weight non-invasively. Bioelectrical Impedance Analysis (BIA) is widely available in overseas but not readily available in all dialysis center in Indonesia, while inferior vena cava diameter is a relatively inexpensive method, and readily available in all dialysis center because it can be performed with ultrasonography (USG) instrument. Methods. A cross-sectional study was performed in a group of regular HD patients at the Haemodialysis Unit, Cipto Mangunkusumo Hospital in Jakarta, June 2011. Dry weight was evaluated with bioelectrical impedance analysis, while the inferior vena cava collapsibility index was evaluated using USG performed by two different observer. Results. We have recruited 30 HD patients, in which 18 (60%) of the subjects were overload according to the bioelectrical impedance analysis, while 21 (70%) were overload according to the inferior vena cava collapsibility index. The mean age of the subjects is 52 years old with the minimum 24 and maximum 69 years. In this research, we found negative correlation (r = -0.957, P<0.0001) between inferior vena cava colapsibility index and BIA. We found a 94.4% sensitivity and 66.7% specificity for inferior vena cava colapsibility index. Both of USG operators showed a κ coefficient value of 0.92, which reflected a very strong agreement between them. Conclusions. The inferior vena cava colapsibility index have a good role as a screening method in determining dry weight in dialysis patients. Keywords: Hemodialysis, dry weight, bioelectrical impedance analysis, correlation, inferior vena cava colapsibility index.

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Comparison of the inferior vena cava index and inferior vena cava collapsibility index obtained by ultrasound as a measure of body fluid volume status in children with nephrotic syndrome

International Journal of Contemporary Pediatrics ◽

10.18203/2349-3291.ijcp20192032 ◽

2019 ◽

Vol 6 (3) ◽

pp. 1298

Author(s):

Deepesh Gupta ◽

Kusum Devpura ◽

Kamlesh Kumar Agrawal

Keyword(s):

Nephrotic Syndrome ◽

Inferior Vena Cava ◽

Body Fluid ◽

Inferior Vena ◽

Vena Cava ◽

Mean Value ◽

Fluid Volume ◽

Volume Status ◽

Minimum Diameter ◽

Body Fluid Volume

Background: There is triad of hypoalbuminemia, edema, and hyperlipidemia in nephrotic syndrome patients. Management of nephrotic syndrome includes general measures like fluid restriction, emergency albumin transfusions and diuretics that provide symptomatic relief till steroids act. These measures require an assessment of body fluid volume to avoid circulatory failure which is very difficult in these patients because of edema. The objective of the study was to measure and compare the Inferior Vena Cava (IVC) Index and Inferior Vena Cava Collapsibility (IVCC) Index by ultrasound as a measure of body fluid volume status in children with nephrotic syndrome.Methods: The present observational study was conducted in all children of age more than 1 year up to 18 year. There were two groups; group 1 was nephrotic syndrome patients-Initial episode or in relapse and group 2 (Control) was age and sex-matched non-nephrotic children. IVC index and IVCC index were measured and compared in both the groups.Results: Mean value of minimum diameter of IVC during inspiration in cases was 5.91±1.60 mm as compared to 4.53±0.94 mm in controls which was significantly higher in case group {P ˂0.0001}. Mean value of IVC index in cases was 0.88±0.20 cm/m2 as compared to 0.93±0.19 cm/m2 in controls which was non-significant. Mean value of IVCC index in cases (35.61±13.68) was significantly less as compared to controls (52.23±2.01) {P ˂0.0001}.Conclusions: The present study concluded that IVCC index is better indicator of body fluid volume status in nephrotic patients as compare to IVC index.

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Evaluation of volume overload by bioelectrical impedance analysis, NT-proBNP and inferior vena cava diameter in patients with stage 3&4 and 5 chronic kidney disease

Renal Failure ◽

10.3109/0886022x.2013.875815 ◽

2014 ◽

Vol 36 (4) ◽

pp. 495-501 ◽

Cited By ~ 10

Author(s):

Zülfükar Yilmaz ◽

Yaşar Yildirim ◽

Ferhat Oto ◽

Fatma Yilmaz Aydin ◽

Emre Aydin ◽

...

Keyword(s):

Chronic Kidney Disease ◽

Kidney Disease ◽

Inferior Vena Cava ◽

Bioelectrical Impedance Analysis ◽

Inferior Vena ◽

Vena Cava ◽

Volume Overload ◽

Bioelectrical Impedance ◽

Impedance Analysis ◽

Inferior Vena Cava Diameter

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Role of Inferior Vena Cava Filter Retrieval in Patients on Chronic Anticoagulation Therapy

Current Treatment Options in Cardiovascular Medicine ◽

10.1007/s11936-020-00891-1 ◽

2021 ◽

Vol 23 (2) ◽

Author(s):

Savannah Fletcher ◽

Adam Plotnik ◽

Ravi N. Srinivasa ◽

Jeffrey Forris Beecham Chick ◽

John M. Moriarty

Keyword(s):

Inferior Vena Cava ◽

Inferior Vena Cava Filter ◽

Inferior Vena ◽

Treatment Options ◽

Anticoagulation Therapy ◽

Vena Cava ◽

Vena Cava Filter ◽

Venous Thromboembolic

Abstract Purpose of review Describe the role of inferior vena cava filter (IVCF) retrieval in patients on chronic anticoagulation given the overlap of these treatment options in the management of patients with venous thromboembolic disease. Recent findings Despite the increase in IVCF retrievals since the Food and Drug Administration safety communications in 2010 and 2014, retrieval rates remain low. Previous studies have shown that longer filter dwell times are associated with greater risk for filter complications and more difficulty with filter retrievals. Recent findings suggest that complications are more frequent in the first 30 days after placement. Summary The decision to retrieve an optional IVCF is individualized and requires diligent follow-up with consistent re-evaluation of the need for the indwelling IVCF, particularly in those on long-term anticoagulation therapy.

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