Which echocardiographic parameter is a better marker of volume status in hemodialysis patients?

Bio-impedance analysis (BIA) is a preferred method for estimating the volume status. However, it cannot be utilized in daily practice. Since the assessment of the volume status is important and challenging for hemodialysis (HD) patients, the aim of study was to determine the volume status in chronic HD patients using echocardiographic parameters and assess its correlation with BIA.

In this cross-sectional analysis, echocardiography and BIA were performed on 30 chronic HD patients 30 min before and 30 min after dialysis. All the cases of dialysis were performed in the middle of the week. This study also assessed the correlation between echocardiographic parameters and BIA parameters.

There were significant differences between ECW, TBW, and TBW% (TBW/W) before and after HD. Significant differences were observed between echocardiographic parameters of IVCD, IVCDi_min, IVCDi_max before and after the HD. LVEDD, LVESD, LA area, mitral valve inflow, E/E', and IVRT, were improved after dialysis, too. There was a significant correlation between IVCDi_min as an index of volume status, ECW% and TBW% before HD and IVCDi_min change after dialysis had a significant correlation with %ECW change after dialysis. Comparison between hypertensive and non-hypertensive groups indicated IVCDi_min was significantly lower in non-hypertensive group after dialysis.

Our results showed a correlation between IVCDi_min and BIA parameters before HD. So, it seems that IVCDi_min can be a good parameter for determining the volume status of HD patients. However, further studies, with larger sample size and with a prospective study design, are required to confirm these results.