Comparison of the inferior vena cava index and inferior vena cava collapsibility index obtained by ultrasound as a measure of body fluid volume status in children with nephrotic syndrome

Abstract

Background: There is triad of hypoalbuminemia, edema, and hyperlipidemia in nephrotic syndrome patients. Management of nephrotic syndrome includes general measures like fluid restriction, emergency albumin transfusions and diuretics that provide symptomatic relief till steroids act. These measures require an assessment of body fluid volume to avoid circulatory failure which is very difficult in these patients because of edema. The objective of the study was to measure and compare the Inferior Vena Cava (IVC) Index and Inferior Vena Cava Collapsibility (IVCC) Index by ultrasound as a measure of body fluid volume status in children with nephrotic syndrome.Methods: The present observational study was conducted in all children of age more than 1 year up to 18 year. There were two groups; group 1 was nephrotic syndrome patients-Initial episode or in relapse and group 2 (Control) was age and sex-matched non-nephrotic children. IVC index and IVCC index were measured and compared in both the groups.Results: Mean value of minimum diameter of IVC during inspiration in cases was 5.91±1.60 mm as compared to 4.53±0.94 mm in controls which was significantly higher in case group {P ˂0.0001}. Mean value of IVC index in cases was 0.88±0.20 cm/m2 as compared to 0.93±0.19 cm/m2 in controls which was non-significant. Mean value of IVCC index in cases (35.61±13.68) was significantly less as compared to controls (52.23±2.01) {P ˂0.0001}.Conclusions: The present study concluded that IVCC index is better indicator of body fluid volume status in nephrotic patients as compare to IVC index.