Role of IVC Indices to Determine the Volume Status in Edematous Nephrotic Syndrome Children

Abstract

Background: Ultrasonography is a widely used tool for assessment of volume status of nephrotic syndrome in children. Objective: This study aims to assess the efficacy of sonographic assessment of inferior vena cava indices to detect this volume status. Methodology: This cross-sectional study involved around 50 children of steroid-sensitive Nephrotic Syndrome relapse, attending the department of Pediatric Nephrology of Bangladesh Shishu Hospital and Institute. Results: About 64% reported non-hypovolemic status; 36% patients had hypovolemia on the basis of urinary indices. The mean value of Fe Na was 0.24 ± 0.19 Umol/L in non-hypovolemic group and 0.14 ± 0.16 Umol/L in hypovolemic group. On the basis of sonographic assessment of IVC Collapsibility index, 80% were in non-hypovolemic group and 20% were in hypovolemic group. Based on IVC Aortic ratio, 66% belonged to non-hypovolemic patient and 34% in hypovolemic group. Statistically significant relationship was not found between different volume status by urinary indices and IVC collapsibility index (p=0.463) sensitivity and specificity of IVCCI in relation to urinary indices was 27.7%; 84.3% and positive prediction value was 50%. Conclusion: The majority of patients with nephrotic syndrome followed non-hypovolemic status. IVC: Aortic ratio can be better tool for volume assessment in nephrotic syndrome children. However, large scale study should be executed to confirm the efficacy of this tool.