Role of inferior vena cava assessment in volume management in acute kidney injury patients

Intravascular volume assessment is critical to guiding volume management in patients with acute kidney injury (AKI). This study aimed to compare the impact of using inferior vena cava (IVC) diameter and collapsibility index (IVC-CI) measurements versus clinical assessment on the management of volume status and improvement of renal function in patients with AKI.

This prospective comparative study included 88 patients with AKI or AKI on top of chronic kidney disease (CKD) who were randomly allocated into two groups: In group 1, volume status was managed according to IVC assessment, while in group 2, volume status was managed according to clinical assessment. In addition, group 1 patients were assessed clinically and compared with IVC measurements in the same group.

There was moderate agreement between the IVC and clinical methods in diagnosing 86.4% of patients (P < 0.001) within group 1. The percentage of patients with edema increased post-treatment in group 2. There was no statistically significant difference between the two groups regarding renal recovery and survival.

Bedside ultrasonographic IVC assessment is a non-invasive method that can facilitate volume management in AKI patients, helping to administer fluids more wisely without unintended excess fluid administration.