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Venous collapsibility index changes in children on dialysis

Pelin Haciomeroglu1, Ozan Ozkaya, Nazlihan Gunal

  • 1Department of Pediatric Cardiology, Ondokuz Mayis University Children's Hospital, Samsun, Turkey. pelinhoglu@hotmail.com

Nephrology (Carlton, Vic.)
|March 21, 2007
PubMed

Insights

Collapsibility index (CI) effectively assesses fluid status in pediatric dialysis patients. Serial CI measurements provide a reliable guide for managing volume changes in children undergoing hemodialysis (HD) and continuous ambulatory peritoneal dialysis (CAPD).

Area of Science:

  • Pediatric Nephrology
  • Cardiovascular Physiology
  • Renal Replacement Therapy

Background:

  • Hypervolemia is a significant risk factor for cardiac failure in end-stage renal disease (ESRD) patients.
  • Accurate assessment of volume status is crucial in pediatric patients undergoing dialysis.
  • Current methods for volume assessment in children may have limitations.

Purpose of the Study:

  • To evaluate the utility of collapsibility index (CI) in assessing volume status in children on hemodialysis (HD) and continuous ambulatory peritoneal dialysis (CAPD).
  • To determine if CI changes reflect fluid removal after a single dialysis exchange in CAPD patients.

Main Methods:

  • Inferior vena cava diameters were measured in 16 CAPD, 9 HD patients (ages 5-18), and 27 healthy controls.
  • Collapsibility index (CI) was calculated based on subxiphoidal long-axis measurements of the inferior vena cava.
  • Measurements were taken before and after dialysis (HD) or dialysate exchange (CAPD).

Main Results:

  • CI was significantly lower in HD patients pre-dialysis and CAPD patients pre-exchange compared to controls.
  • CI increased significantly after HD, approaching control levels.
  • While CI changed significantly after dialysate exchange in CAPD patients, it remained lower than in controls.

Conclusions:

  • Serial CI measurements are valuable for monitoring individual volume status changes in pediatric dialysis patients.
  • CI can serve as a useful, non-invasive tool for guiding fluid management in children on HD and CAPD.
  • Continuous monitoring of CI may offer a more accurate reflection of volume status than single measurements.
Abstract

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