Research Journal of Medical Sciences
ISSN: Online 1993-6095ISSN: Print 1815-9346
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Abstract
Nephrotic syndrome is the most common renal disease in children, characterized by edema due to fluid accumulation in the interstitial fluid compartment. Edema in nephrotic syndrome can be explained by the underfill and overfill hypotheses. The underfill hypothesis suggests that hypoalbuminemia leads to fluid sequestration in the interstitial compartment, while the overfill hypothesis attributes edema to a primary renal defect in sodium excretion. Accurate assessment of intravascular volume status is crucial for effective treatment. This study compares the Inferior Vena Cava Index (IVCI) and Inferior Vena Cava Collapsibility Index (IVCCI) as measures of body fluid volume in children with nephrotic syndrome. This cross‐sectional observational study was conducted in the Department of Pediatrics at Pt B D Sharma PGIMS, Rohtak. A total of 60 children aged 1‐14 years were included, with 30 children diagnosed with nephrotic syndrome (cases) and 30 healthy children (controls). IVCI and IVCCI were measured using ultrasound and the body surface area was calculated. Statistical analysis was performed using SPSS version 21.0, with significance set at p<0.05. The mean age of cases was 5.57±3.02 years and controls were 5.73±3.10 years. The mean IVC diameter at inspiration and expiration was significantly higher in cases (0.70±0.24 cm and 0.92±0.29 cm, respectively) compared to controls (0.51±0.12 cm and 0.68±0.10 cm, respectively) (p=0.001). The mean IVCI was significantly higher in cases (1.07±0.39) compared to controls (0.44±0.19) (p=0.001). There was no significant difference in mean IVCCI between cases (24.65±10.16) and controls (25.41±11.62) (p=0.787). Based on IVCI, 20% of cases were hypovolemic, 46.7% were euvolemic and 33.3% were hypervolemic. All cases were hypervolemic according to IVCCI, while 3.3% of controls were hypovolemic or euvolemic and 96.7% were hypervolemic. IVCI underestimated body fluid volume status in both control and nephrotic syndrome children, while IVCCI overestimated intravascular volume status. The study supports the overfill hypothesis, with 33.3% of edematous patients showing IVCI >1.15 and IVCCI <50%. Further studies are needed to define accurate cut‐offs for IVCI and IVCCI in Indian children.
How to cite this article:
Pooja , Anand Parashar and Vijay Kumar. Comparative Analysis of Inferior Vena Cava Index and Collapsibility Index as Indicators of Body Fluid Volume Status in Children with Nephrotic Syndrome.
DOI: https://doi.org/10.36478/10.36478/makrjms.2024.10.151.155
URL: https://www.makhillpublications.co/view-article/1815-9346/10.36478/makrjms.2024.10.151.155