Can Nephrologists Use Ultrasound to Evaluate the Inferior Vena Cava? A Cross-Sectional Study of the Agreement between a Nephrologist and a Cardiologist.

Nephron Extra Pub Date : 2014-04-30 eCollection Date: 2014-01-01 DOI:10.1159/000362170

José Muniz Pazeli, Daniel Fagundes Vidigal, Tarcísio Cestari Grossi, Natália Maria Silva Fernandes, Fernando Colugnati, Rogério Baumgratz de Paula, Hélady Sanders-Pinheiro

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引用次数: 25

Abstract

Background/aims: The costs and the need for a specialist impair the implementation of ultrasonography for evaluating the inferior vena cava (IVC) to assess the volemic status in hemodialysis patients. We investigated whether a nephrologist with limited ultrasound training can accurately assess the IVC in patients undergoing hemodialysis.

Methods: A cardiologist and a nephrologist consecutively measured the indexed IVC expiratory diameter (VCDi) and the IVC collapsibility index (IVCCI) of 52 patients during hemodialysis sessions. In protocol I, the nephrologist used a regular ultrasound system (RUS) and the cardiologist used a cardiovascular ultrasound equipment; in protocol II, the machines were interchanged. Pearson and kappa coefficients and the interexaminer agreement by the Bland-Altman method were calculated.

Results: The VCDi measurements showed a strong correlation in both protocols (r = 0.88 and 0.84 in protocols I and II, respectively). The volemic classifications were excellent in protocol I (kappa = 0.82 and 0.93 by VCDi and IVCCI, respectively) and substantial in protocol II (kappa = 0.77 and 0.75 by VCDi and IVCCI, respectively). The interexaminer agreement on the VCDi measurements was very good in both protocols.

Conclusions: Ultrasound evaluation of the IVC can be performed by nephrologists using an RUS to assess the volemic status in hemodialysis patients.

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肾内科医生可以用超声评估下腔静脉吗?肾科医生和心脏病科医生协议的横断面研究。

背景/目的:超声检查下腔静脉(IVC)以评估血液透析患者血容量状态的成本和对专科医生的需求影响了超声检查的实施。我们调查了接受有限超声训练的肾脏科医生能否准确评估血液透析患者的IVC。方法:由心脏科医师和肾病科医师连续测量52例血液透析患者的下腔静脉呼气直径指数(VCDi)和下腔静脉湿陷指数(IVCCI)。在方案1中，肾病专家使用常规超声系统(RUS)，心脏病专家使用心血管超声设备;在协议II中，机器是互换的。通过Bland-Altman方法计算Pearson系数和kappa系数以及考官之间的一致性。结果:VCDi测量值在两种方案中显示出很强的相关性(方案I和方案II的r分别为0.88和0.84)。方案I的血容量分类很好(VCDi和IVCCI kappa分别为0.82和0.93)，方案II的血容量分类很好(VCDi和IVCCI kappa分别为0.77和0.75)。在两种方案中，审查员对VCDi测量结果的一致性非常好。结论:超声评估下腔静脉可以由肾科医师使用RUS评估血液透析患者的容血状态。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Nephron Extra

自引率

0.00%

发文量

审稿时长

12 weeks

期刊介绍： An open-access subjournal to Nephron. ''Nephron EXTRA'' publishes additional high-quality articles that cannot be published in the main journal ''Nephron'' due to space limitations.