Assessment of volemia status using ultrasound examination of the inferior vena cava and spectroscopic bioimpendance in hemodialysis patients

Background/Aim. Hypervolemia is an important risk factor for the development of cardiovascular morbidity and mortality in patients treated with regular hemodialysis. There is still no reliable method for assessing the status of volemia in these patients. The aim of the study was to assess the status of volemia in patients treated with regular hemodialysis by measuring the parameters of the inferior vena cava and bioimpedance. Methods. Authors examined the effect of hemodialysis treatment on ultrasound parameters of the inferior vena cava, as well as on the parameters measured by bioimpedance before and after hemodialysis. The N-terminal prohormone of brain natriuretic peptide (NT-proBNP) values were measured both before and after hemodialysis. Patients (45) were involved in the non-interventional cross-section study, who were treated with standard bicarbonate dialysis. According to the intradialytic yield, the patients were divided into three groups: I (up to 2000 ml), II (2000-3000 ml), III (over 3000 ml). Results. The values of the inferior vena cava parameters and the parameters measured with bioimpedance are significantly lower after treatment with hemodialysis (p<0.005). The third group of patients had a significantly higher total fluid volume in the body, compared to group I, as well as significantly greater volume of extracellular fluid (p<0.005). Significantly lower values of NT-proBNP in all groups (p<0.005) were detected after hemodialysis. After treatment with hemodialysis, a positive correlation was observed between the concentration of NT-proBNP in the serum and the extracellular/intracellular water ratio, however, the correlation between NT-proBNP concentration and total fluid measured by bioimpedance spectroscopy did not reach statistical significance. Conclusion. Measurement of the inferior vena cava ultrasound parameters and volemia parameters using bioimpendance significantly contributes to the assessment of the status of volemia, but it can’t be used as a separate parameter, but in combination with all other methods.