Related Experiment Video
Updated: Feb 16, 2026
Author Spotlight: Utilizing Venoplasty Balloon Model in Rodents to Simulate Surgical Interventions for Deep Veins
Published on: May 24, 2024
Fluid status evaluation by inferior vena cava diameter and bioimpedance spectroscopy in pediatric chronic
Xavier Torterüe1, Laurène Dehoux1, Marie-Alice Macher1
1Department of Paediatric Nephrology and Hemodialysis, Hôpital Robert Debré, APHP, 48 boulevard Sérurier 75019, 19, Paris Cedex, France.
Insights
Inferior Vena Cava (IVC) measurements are not reliable for assessing fluid overload in children undergoing hemodialysis (HD). However, IVC may help distinguish between volume-dependent and independent hypertension.
Area of Science:
- Pediatric Nephrology
- Cardiovascular Physiology
- Medical Imaging
Background:
- Assessing dry weight in pediatric chronic hemodialysis (HD) is challenging.
- Inferior Vena Cava (IVC) measurements have shown potential for fluid overload assessment in both adults and children.
Purpose of the Study:
- To evaluate the relationship between predialytic IVC diameter and hydration status in children on HD.
- To assess the correlation between IVC measurements and persistent hypertension post-dialysis.
Main Methods:
- A monocentric prospective study analyzed 48 HD sessions in 16 pediatric patients.
- Hydration status was assessed by physician evaluation and bioimpedance spectroscopy (BIS).
- IVC diameter measurements (inspiratory, expiratory, collapsibility index) were taken predialysis.
Main Results:
- Physician assessment indicated overhydration in 84.5% of sessions; BIS indicated 20.8%.
- IVC measurements showed no correlation with BIS-derived overhydration (p=0.20).
- Patients with normalized blood pressure had more dilated IVC pre-dialysis compared to those with persistent hypertension (p=0.03).
Conclusions:
- IVC measurement is unreliable for assessing fluid overload in pediatric HD patients.
- IVC measurements did not correlate with extracellular fluid volume measured by BIS.
- IVC may be useful in differentiating volume-dependent from volume-independent hypertension.
Background:
Evaluation of patient's dry weight remains challenging in chronic hemodialysis (HD) especially in children. Inferior Vena Cava (IVC) measurement was reported useful to assess fluid overload both in adults and children.
Methods:
We performed a monocentric prospective study to evaluate the relation between predialytic IVC diameter measurements and hydration status evaluated by physicians and bioimpedance spectroscopy (BIS) and between IVC measurements and persistent hypertension.
Results:
Forty-eight HD sessions in 16 patients were analyzed. According to physicians, patients were overhydrated in 84.5% of dialysis sessions, 20.8% according to BIS, and 0%, 4.1% and 20.8% according to IVC inspiratory, expiratory and collapsibility index reference curves respectively. There was no correlation between relative overhydration evaluated by BIS and IVC measurements z-scores (p = 0.20). Patients whose blood pressure normalized after HD had a more dilated maximal IVC diameter before dialysis session than patients with persistent hypertension (median - 0.07SD [-0.8; 0.88] versus -1.61SD [-2.18; -0.74] (p = 0.03)) with an optimal cut-off of -0.5 SD.
Conclusions:
In our study, IVC measurement is not reliable to assess fluid overload in children on HD and was not correlated with extracellular fluid volume assessed by BIS measurements. However, IVC measurements might be of interest in differentiating volume-dependant hypertension from volume-independant hypertension.
Related Concept Videos
01:25Hemodialysis I: Introduction
01:24Hemodialysis II: Procedure and Complications
01:25Hemodialysis III: Nursing Management
01:26Marcia's Theory of Identity Status
01:30Extracorporeal Removal of Drugs: Peritoneal Dialysis and Hemodialysis
01:17Design Example: Calculating Safe Diameter for Wind-Exposed Disc