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. 2014 Apr 30;4(1):82-8.
doi: 10.1159/000362170. eCollection 2014 Jan.

Can Nephrologists Use Ultrasound to Evaluate the Inferior Vena Cava? A Cross-Sectional Study of the Agreement between a Nephrologist and a Cardiologist

José Muniz Pazeli  1 , Daniel Fagundes Vidigal  2 , Tarcísio Cestari Grossi  3 , Natália Maria Silva Fernandes  4 , Fernando Colugnati  4 , Rogério Baumgratz de Paula  4 , Hélady Sanders-Pinheiro  4
Affiliations

Can Nephrologists Use Ultrasound to Evaluate the Inferior Vena Cava? A Cross-Sectional Study of the Agreement between a Nephrologist and a Cardiologist

José Muniz Pazeli et al. Nephron Extra. .

Abstract

Background/aims: The costs and the need for a specialist impair the implementation of ultrasonography for evaluating the inferior vena cava (IVC) to assess the volemic status in hemodialysis patients. We investigated whether a nephrologist with limited ultrasound training can accurately assess the IVC in patients undergoing hemodialysis.

Methods: A cardiologist and a nephrologist consecutively measured the indexed IVC expiratory diameter (VCDi) and the IVC collapsibility index (IVCCI) of 52 patients during hemodialysis sessions. In protocol I, the nephrologist used a regular ultrasound system (RUS) and the cardiologist used a cardiovascular ultrasound equipment; in protocol II, the machines were interchanged. Pearson and kappa coefficients and the interexaminer agreement by the Bland-Altman method were calculated.

Results: The VCDi measurements showed a strong correlation in both protocols (r = 0.88 and 0.84 in protocols I and II, respectively). The volemic classifications were excellent in protocol I (kappa = 0.82 and 0.93 by VCDi and IVCCI, respectively) and substantial in protocol II (kappa = 0.77 and 0.75 by VCDi and IVCCI, respectively). The interexaminer agreement on the VCDi measurements was very good in both protocols.

Conclusions: Ultrasound evaluation of the IVC can be performed by nephrologists using an RUS to assess the volemic status in hemodialysis patients.

Keywords: Agreement; Fluid status; Hemodialysis; Inferior vena cava; Point-of-care ultrasonography.

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Figures

Fig. 1
Fig. 1
Design of the study. HD = Hemodialysis; CKD = chronic kidney disease.
Fig. 2
Fig. 2
The Bland-Altman graph.
See this image and copyright information in PMC

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References

    1. Agarwal R. Hypervolemia is associated with increased mortality among hemodialysis patients. Hypertension. 2010;56:512–517. - PMC - PubMed
    1. Pecoits-Filho R, Bucharles S, Barberato SH. Diastolic heart failure in dialysis patients: mechanisms, diagnostic approach, and treatment. Semin Dial. 2012;25:35–41. - PubMed
    1. London GM. Ultrafiltration intensification for achievement of dry weight and hypertension control is not always the therapeutic gold standard. J Nephrol. 2011;24:395–397. - PubMed
    1. Curatola G, Bolignano D, Rastelli S, Caridi G, Tripepi R, Tripepi G, et al. Ultrafiltration intensification in hemodialysis patients improves hypertension but increases AV fistula complications and cardiovascular events. J Nephrol. 2011;24:465–473. - PubMed
    1. Wang AY, Lai K-N. The importance of residual renal function in dialysis patients. Kidney Int. 2006;69:1726–1732. - PubMed

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