Enhancement of Quality of Life with Adjustment of Dry Weight by Echocardiographic Measurement of Inferior Vena cava Diameter in Patients Undergoing Chronic Hemodialysis

摘要

Background/Aims: Ideal dry weight (DW) can serve as a marker of good quality of life (QOL) in patients receiving chronic hemodialysis. The size of the inferior vena cava (IVC) reflects the intravascular fluid status, and the diameter of IVC correlates indirectly with DW in these patients. Adjusting DW using echocardiographic measurement of the diameter of the IVC thus may be useful in maintenance of a better QOL in patients receiving chronic hemodialysis. Methods: This study included 119 patients with ages ranging between 27 and 90 years (mean +- standard deviation of 58.3 +- 12.8). All of the patients received the IVC diameter (IVCD) measurement by echocardiography every 2 months for 1 year. The study group included 68 patients in whom the DW were adjusted by echocardiographic measurement of the IVCD, while the control group included 51 patients in whom the DW was adjusted by the conventional method. QOL was evaluated using the short form 36 questionnaire (SF-36) at the beginning and at the end of the study. Besides, the Kt/V_(urea) value, a parameter of total urea clearance, was measured at the beginning and at the end of the study in patients of both groups. Results: The scores of physical functioning, physical role functioning, general health and physical component summary showed a prominent improvement in the study group but not in the control group. The impact of periodic echocardiographic evaluation also demonstrated a significant change in the scores of physical functioning, physical role functioning and physical component summary in the study group. Furthermore, the Kt/V_(urea) value, a parameter of total urea clearance, also increased significantly in the study group. Conclusion: Ideal DW is better adjusted by periodic echocardiographic measurement of the IVCD in patients undergoing chronic hemodialysis. Maintenance of a better DW leads to improve hemodialysis quality and QOL in these patients.