title: Usefulness of US imaging in overhydrated nephropathic patients.
abstract: Achievement of a normal hydration status is one of the major targets of hemodialysis. It is based on the estimation of "dry weight", the term used to define normal body fluid content. The concept of dry weight in hemodialysis patients is clinically undisputed, but it is not always easy to achieve in this population. Assessment of hydration status by clinical evaluation is imprecise and often unreliable. Measurement of the inferior vena cava (IVC) diameter has been shown to reflect individual fluid status. The relationship between variation in IVC diameter before and after hemodialysis session and weight loss has been investigated. Ultrasound (US) measurement of the IVC diameter is considered a valid measure of the hydration status and is routinely used in hemodialysis patients. Moreover, a relationship between IVC diameter, respiratory activity and hydration status, evaluated by considering both plasma volume and central venous pressure, has been demonstrated. In conclusion, assessment of hydration status based on blood pressure and central venous pressure can be considered reliable only in patients without signs of heart failure.
authors.affiliation: Nephrology and Dialysis Unit, "Casa Sollievo della Sofferenza" Hospital, San Giovanni Rotondo, Foggia Italy.
authors.forename: Michele
authors.initials: M
authors.lastname: Prencipe
authors.affiliation: Nephrology and Dialysis Unit, "St. Giovanni di Dio" Hospital, C.da Consolida, 92100 Agrigento, Italy ; Advanced School of Ultrasonography in Nephrology - SIUMB, Milan, Italy.
authors.forename: Antonio
authors.initials: A
authors.lastname: Granata
authors.affiliation: Nephrology and Dialysis Unit, "Vito Fazzi" Hospital, Lecce, Italy.
authors.forename: Alessandro
authors.initials: A
authors.lastname: D'Amelio
authors.affiliation: Internal Medicine Unit, AOU "Vittorio Emanuele-Policlinico", Catania, Italy.
authors.forename: Giulia
authors.initials: G
authors.lastname: Romano
authors.affiliation: Nephrology and Dialysis Unit, "Casa Sollievo della Sofferenza" Hospital, San Giovanni Rotondo, Foggia Italy.
authors.forename: Filippo
authors.initials: F
authors.lastname: Aucella
authors.affiliation: Nephrology and Dialysis Unit, "S. M. della Misericordia" Hospital, ASL 18, Rovigo, Italy ; Advanced School of Ultrasonography in Nephrology - SIUMB, Milan, Italy.
authors.forename: Fulvio
authors.initials: F
authors.lastname: Fiorini
mesh_terms: D001794:Blood Pressure; D001826:Body Fluids / Q000000981:diagnostic imaging*; D001835:Body Weight; D002496:Central Venous Pressure; D006801:Humans; D007676:Kidney Failure, Chronic / Q000628:therapy*; D006435:Renal Dialysis; D014463:Ultrasonography; D014682:Vena Cava, Inferior / Q000000981:diagnostic imaging*
keywords: Chronic kidney disease; Hemodialysis; Overhydratation; Ultrasonography