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

Figures & data

Table 1. Comparison of hemodynamic parameters pre- and post-hemodialysis.

Index	Pre-HD (mean ± SD)	Post-HD (mean ± SD)	Change (mean ± SD)	p Value^a
Mean weight (kg)	72.2 ± 16.6	70.2 ± 16.3	2.01 ± 0.8	<.001
Mean SBP (mmHg)	140 ± 21	126 ± 21	14 ± 20	.001
Mean DBP (mmHg)	83 ± 12	74 ± 11	10 ± 11	<.001
Mean Hct (%)	35.3 ± 5.7	37.1 ± 6.8	−1.7 ± 2.3	<.001

HD: hemodialysis.

^a Paired t test.

Table 2. Comparison of echocardiographic parameters pre- and post-hemodialysis.

Parameter	Pre-HD (mean ± SD)	Post-HD (mean ± SD)	Change (mean ± SD)	p Value^a
LVEF (%)	53.5 ± 2.6	53.8 ± 2.5	−0.33 ± 1.8	.326
IVCD (cm)	2.08 ± 2.1	1.4 ± 1.6	0.65 ± 1.06	.002
LA area (cm^2)	22.3 ± 4.7	19.8 ± 4.8	2.54 ± 2.7	.001
LAD (cm)	3.7 ± 0.56	3.4 ± 0.53	0.31 ± 0.37	<.001
LVEDD (cm)	4.7 ± 0.5	4.4 ± 0.6	0.28 ± 0.25	<.001
LVESD (cm)	2.8 ± 0.5	2.6 ± 0.5	0.135 ± 0.3	.020
MVI	1.27 ± 0.77	1.04 ± 0.55	0.22 ± 0.42	.006
E′	6.9 ± 1.9	7.03 ± 1.9	−0.13 ± 1.9	.716
E/E′	13.6 ± 4.1	11.1 ± 4.6	2.47 ± 3.11	<.001
IVRT (ms)	86.3 ± 20	94.2 ± 24.7	−7.9 ± 14.4	.006
IVS (cm)	1.17 ± 1.33	0.92 ± 0.22	0.24 ± 1.3	.323
IVCCI (%)	2.3 ± 9.9	2.3 ± 9.5	−0.001 ± 0.46	.991
IVCDimax (mm)	8.86 ± 2.7	6.3 ± 2.5	2.54 ± 2.2	<.001
IVCDimin (mm)	4.3 ± 2.3	2.3 ± 1.6	2.03 ± 2.02	<.001
DT (ms)	198.8 ± 53.8	190 ± 48.8	8.06 ± 52.3	.406
PCWP (mmHg)	17.9 ± 5	15.2 ± 5.7	2.75 ± 3.8	<.001
PAP (mmHg)	34.4 ± 7.03	29.2 ± 6.8	5.2 ± 4.2	<.001

LVEF: left ventricular ejection fraction; IVCD: inferior vena cava diameter; LA: left atrial; LAD: LA diameter; LVEDD: LV end diastolic diameter; LVESD: LV end systolic diameter; MVI: mitral valve inflow; IVRT: isovolumic relaxation time; IVS: interventricular septum; IVCCI: inferior vena cava collapse-ability index; IVCDi_max: IVCD_max/BSA; IVCDi_min: IVCD_min/BSA; DT: deceleration time; PCWP: pulmonary capillary wedge pressure; PAP: pulmonary artery pressure; HD: hemodialysis.

^a Paired t test.

Table 3. Comparison of bio-impedance analysis (BIA) parameters pre- and post-hemodialysis.

Parameter	Pre-HD (mean ± SD)	Post-HD (mean ± SD)	Change (mean ± SD)	p Value^a
ECW (L)	16.7 ± 5.2	14.5 ± 2.9	2.2 ± 5.4	.035
TBW (L)	42.84 ± 14.7	35.2 ± 8.7	7.6 ± 16	.018
ECW%	23.7 ± 6.9	21.3 ± 4.4	2.4 ± 7.1	.072
TBW%	60 ± 18.2	51.5 ± 14	8.4 ± 20.7	.040

ECW: extracellular water; TBW: total body water; ECW%: ECW/Weight (%); TBW%: TBW/Weight (%); HD: hemodialysis.

^a Paired t test.

Table 4. Pearson correlation coefficient between BIA and echocardiographic parameters before and after hemodialysis.

	Pre-HD				Post-HD
	ECW	ECW%	TBW	TBW%	ECW	ECW%	TBW	TBW%
IVCD	0.13	−0.02	0.04	−0.08	0.09	−0.07	0.07	−0.07
E′	−0.05	−0.04	−0.007	−0.02	−0.04	0.05	−0.04	0.02
E/E′	−0.03	0.20	0.15	0.006	−0.20	−0.16	−0.19	−0.18
IVCCI	0.03	−0.08	−0.08	−0.19	0.09	−0.08	−0.06	−0.17
IVCDimax	−0.03	0.27	−0.03	0.27	−0.18	0.09	−0.22	0.05
IVCDimin	0.24	0.39^b	0.31	0.46^a	−0.19	0.29	−0.26	0.7

IVCD: inferior vena cava diameter; IVCCI: inferior vena cava collapse-ability index; IVCDi_max: IVCD_max/BSA; IVCDi_min: IVCD_min/BSA; ECW: extracellular water; TBW: total body water; ECW%: ECW/Weight (%); TBW%: TBW/Weight (%); HD: hemodialysis.

^a p values = .01.

^b p values = .03.

Table 5. Comparison of echocardiographic parameters between hypertensive and non-hypertensive group before and after hemodialysis.

	Hypertensive (mean ± SD)	Non-hypertensive (mean ± SD)	p Values^a
LVEF%
Pre-HD	53 ± 2	53 ± 3	.830
Post-HD	53 ± 2	53 ± 3	.750
IVCD (cm)
Pre-HD	2.1 ± 2.4	1.8 ± 1.7	.710
Post-HD	1.6 ± 2	1.02 ± 0.4	.320
LA area (cm^2)
Pre-HD	21.6 ± 3.6	22.3 ± 6	.710
Post-HD	20.1 ± 4	19.1 ± 6	.660
LAD (cm)
Pre-HD	3.9 ± 0.5	3.4 ± 0.45	.030
Post-HD	3.5 ± 0.55	3.2 ± 0.51	.240
LVEDD (mm)
Pre-HD	4.9 ± 0.4	4.4 ± 0.5	.020
Post-HD	4.6 ± 0.5	4.2 ± 0.6	.090
LVESD (mm)
Pre-HD	3 ± 0.5	2.5 ± 0.4	.010
Post-HD	2.8 ± 0.5	2.4 ± 0.4	.100
MVI (cm/s)
Pre-HD	1.3 ± 0.7	1.2 ± 0.7	.780
Post-HD	1.04 ± 0.5	1.05 ± 0.6	.980
E′ (cm/s)
Pre-HD	6.5 ± 1.5	7.5 ± 2.4	.170
Post-HD	6.3 ± 1.7	8.1 ± 1.8	.010
E/E′
Pre-HD	14.6 ± 3.9	11.9 ± 4.1	.090
Post-HD	12.1 ± 4.6	9.4 ± 4.2	.110
IVRT (ms)
Pre-HD	87 ± 21	85 ± 19	.810
Post-HD	98 ± 25	87 ± 22	.270
IVS (cm)
Pre-HD	0.96 ± 0.2	1.5 ± 2.1	.420
Post-HD	0.96 ± 0.2	0.86 ± 0.15	.270
IVCCI
Pre-HD	3.4 ± 12.4	0.63 ± 0.22	.470
Post-HD	3.3 ± 12	0.7 ± 0.2	.470
IVCDimax (cm)
Pre-HD	9.2 ± 2.5	8.1 ± 3.10	.290
Post-HD	6.6 ± 2.4	5.7 ± 2.7	.360
IVCDimin (cm)
Pre-HD	4.8 ± 2.5	3.5 ± 1.5	.140
Post-HD	2.8 ± 1.6	1.4 ± 1.2	.020
DT (ms)
Pre-HD	195 ± 53	205 ± 56	.610
Post-HD	192 ± 45	187 ± 56	.760
PAP (mmHg)
Pre-HD	36.2 ± 8.1	33.6 ± 8.4	.410
Post-HD	28 ± 6.3	31 ± 8.4	.270

LVEF: left ventricle ejection fraction; IVCD: inferior vena cava diameter; LA: left atrial; LAD: LA diameter; LVEDD: LV end diastolic diameter; LVESD: LV end systolic diameter; MVI: mitral valve inflow; IVRT: isovolumic relaxation time; IVS: interventricular septum; IVCCI: inferior vena cava collapse-ability index; IVCDi_max: IVCD_max/BSA; IVCDi_min: IVCD_min/BSA; DT: deceleration time; PAP: pulmonary artery pressure; HD: hemodialysis.

^a Independent sample t test.

Bold value signifies p values (< .05).