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Background/Aim. Hypervolemia is an important risk factor for the development of cardiovascular morbidity and mortality in patients treated with regular hemodialysis. There is still no reliable method for assessing the status of volemia in these patients. The aim of the study was to assess the status of volemia in patients treated with regular hemodialysis by measuring the parameters of the inferior vena cava (IVC) and bioimpedance. Methods. The effect of hemodialysis treatment on ultrasound parameters of the IVC, as well as on the parameters measured by bioimpedance, was examined before and after hemodialysis. The values of the N-terminal prohormone of brain natriuretic peptide (NT-proBNP) were measured both before and after hemodialysis. Forty-five patients were involved in this non-interventional cross-section study, including the patients treated with standard bicarbonate dialysis. According to the interdialytic yield, the patients were divided into three groups: I (up to 2,000 mL), II (2,000-3,000 mL), and III (over 3,000 mL). Results. The values of the IVC parameters and the parameters measured with bioimpedance were significantly lower after treatment with hemodialysis (p < 0.005). The third group of patients had a significantly higher total fluid volume in the body compared to the group I, as well as a significantly greater volume of extracellular fluid (p < 0.005). The significantly lower values of NT-proBNP in all groups (p < 0.005) were detected after hemodialysis. After treatment with hemodialysis, a positive correlation was observed between the concentration of NT-proBNP in the serum and the extracellular/intracellular water ratio. However, the correlation between NT-proBNP concentration and total fluid measured by bioimpedance spectroscopy did not reach statistical significance. Conclusion. Measurement of the IVC ultrasound parameters and volemia parameters using bioimpedance significantly contributes to the assessment of the status of volemia. Nevertheless, it cannot be used as a separate parameter, only in combination with all other methods. [ABSTRACT FROM AUTHOR]

Background/Aim. The absence of clear guidance in the definition, diagnostics, and indications for renal replacement treatment (RRT) is present. The aim of this study was to help outlining future clinical work in improving the treatment outcome and reducing complications of acute kidney injury (AKI) based on the current clinical practice. Methods. The questionnaires were distributed among physicians of different specialties who participated voluntarily and anonymously. The questionnaire was drawn up in accordance with the standard clinical practice. Results. We conducted a multicentric web survey among nephrologists (46.8%) and other physicians in Serbia. The sample consisted of 119 participants, out of which 78.9% filled out the survey forms correctly and were, therefore, included in the analysis. Most of them responded that the nephrologist indicates (76.8%) and prescribes (74.5%) continuous renal replacement therapy (CRRT). The application of the Kidney Disease Improving Global Outcomes (KDIGO) 2 criterion for "early" start of CRRT used 74.5% of the respondents, and 91.5% of them started "late" initiation of CRRT in the presence of complications associated with AKI or poor response to conservative treatment. Regarding the clinical experience of the respondents, 74.5% of them marked the "early" start of CRRT within 12 hours, whereas 56.4% of them considered the start of CRRT after 48 h as "late". The most commonly used modality was continuous venous hemodiafiltration (37.6%). Most participants used heparin as an anticoagulant (95.7%) with an average life span of filters less than 24 h (71.3%) and 25 mL/kg/h efficiency target dialysis effluent dose (45.2%) during CRRT. The most common complications of CRRT were hypotension (55.3%) and catheter-related infections (29.8%). Conclusion. The "early" start of CRRT is considered favorite by the majority of the participants. According to the obtained data, standardization of the strategy in the diagnostics and treatment of AKI is necessary. [ABSTRACT FROM AUTHOR]