Lung ultrasound and bioimpedance in assessment of volume status of hemodialysis patients

Youssef, Ghada; Zayed, Bahaa; Momtaz, Mohammed; Roshdy, Amin; Shaaban, Mohamed

doi:10.4103/2356-8097.207188

Cited by 4 publications

(2 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In the authors' study, hypertension was the most common comorbidity seen among patients with CKD (97%), followed by diabetes (52%), coronary artery disease (CAD [15%]), and chronic obstructive pulmonary disease (9%). Similarly, studies by Kuzuhara et al 14 and Youssef et al 15 showed that hypertension was the commonest comorbidity seen among patients with CKD, accounting for 41 (83.7%) and 30 (75.0%) cases, respectively. Other studies by Fraser et al 16 In this study, high BP (≥140/90 mmHg) was found in most patients during the pre-dialysis period (i.e., 62% of the assessments).…”

Section: Discussionmentioning

confidence: 76%

Utility of Bedside Lung Ultrasound in the Assessment of Volume Status in Patients on Chronic Haemodialysis

Jeswani¹,

Bhardwaj

Bhatt

2023

EMJ Radiol

View full text Add to dashboard Cite

Aim: The estimation of the ‘dry weight’ in a patient on haemodialysis with end-stage renal disease is an important clinical challenge to date. Physical examination has its limitations in the precise assessment of volume status. The monitoring of blood volume, natriuretic peptides, and bioimpedance spectroscopy are explored as a guide for the ultrafiltration process during haemodialysis (HD) therapy. Unfortunately, none of these methods has shown promising results when used in isolation and has serious limitations. The point-of-care lung ultrasonography has emerged recently as an adjunct to physical examination as a non-invasive, radiation-free technique to estimate extravascular lung water. In this study, the authors aimed to compare the volume status assessment in end-stage renal disease patients on HD using conventional clinical methods, bio-electrical impedance, and chest ultrasound (US). Materials and Methods: A prospective cohort study was conducted on 34 patients undergoing regular HD in the Department of Nephrology dialysis centre at the University College of Medical Sciences Guru Teg Bahadur Hospital, Delhi, India, a multi-speciality tertiary care centre. Parameters included to assess the dry weight of patients were bio-impedance spectroscopy and chest US, measured in two phases: 30 minutes before and 10–60 minutes following the HD session. Results: A total of 100 assessments were done on 34 patients over 6 months. The mean pre-HD extracellular water was 17.52±2.69 L and post-HD was 16.38±2.46 L, showing a significant reduction (<0.001). The bioimpedance analysis showed that 44% of the volume status assessments had fluid overload (≥1.1 L), even when the patients were considered to be in a state of clinical euvolemia, while 79% of the assessments had a Comet Score of ≥3 suggesting a fluid overload state. Most assessments showed a significant reduction in the number of B-lines (i.e., 62% [Comet Score of between 0–2]). The mean post-HD Comet Score was 1.73±1.36 (37%). Conclusion: Chest US to assess Comet Score is highly correlated with the clinical signs and symptoms. Lung Comet Scores can also be highly correlated with ultrafiltration volume, and thus can be used as a good marker for achieving dry weight in dialysis patients.

show abstract

Section: Discussionmentioning

confidence: 76%

Utility of Bedside Lung Ultrasound in the Assessment of Volume Status in Patients on Chronic Haemodialysis

Jeswani¹,

Bhardwaj

Bhatt

2023

EMJ Radiol

View full text Add to dashboard Cite

show abstract

“…Bioimpedance may be more effective in the hydration status detection, while US may show cardiac and overhydration findings. The effect of dialysis can also be demonstrated (39).…”

Section: Correlation With Ultrasonographymentioning

confidence: 97%

Use of Bioimpedance in Pediatrics

Dirik¹,

Beyitler²

2018

Cyprus J Med Sci

View full text Add to dashboard Cite

Bioimpedance analysis is an easy, rapid, cheap, noninvasive, effective, and portable technique that can be utilized in several pediatric health conditions. The fluid status evaluation, edema, obesity, malnutrition, inflammation, infection, pain, attention deficit/hyperactivity disorder, nephrourological evaluation, gastroesophageal reflux, and neonatal problems are some of the issues studied with bioimpedance. As the pediatric-age group is usually difficult to manage, such practical and accurate methods are promising for better results.

show abstract

Assessment of volume status of pediatric hemodialysis patients

Fadel,

Salah,

Mawla

et al. 2024

Pediatr Nephrol

View full text Add to dashboard Cite

Background Accurate volume status assessment and dry weight achievement are the most challenging goals for a nephrologist. We aimed to evaluate the role of ultrasonographic parameters including lung ultrasound and inferior vena cava (IVC) measurements as practical methods of volume status assessment in children on hemodialysis by comparing them with established techniques, such as clinical evaluation and bioimpedance spectroscopy. Methods A prospective cross-sectional study compared pre- and post-dialysis volume status using bioimpedance spectroscopy (BIS) parameters and clinical data with ultrasonographic lung B-lines and IVC parameters in children on regular hemodialysis. Results A total 60 children (mean age 9.4 ± 2.8 years) were enrolled. Twenty patients (33.3%) were clinically overloaded to varying degrees (17 patients had mild to moderate signs of fluid overload and 3 patients had moderate to severe signs of fluid overload). All other patients (66.7%) were clinically euvolemic. Sonographic parameters were significantly lower post-dialysis than pre-dialysis, including lung B-line count and IVC diameter. IVC collapsibility index mean was significantly higher post-dialysis than pre-dialysis. There was a significant correlation between the lung B-line count, IVC parameters, and BIS-measured overhydration both before and after hemodialysis. Nine patients had ≥ 8 B-lines post-dialysis, only three of them were hypertensive. Conclusions Clinical criteria alone are not specific for determining accurate fluid status in pediatric hemodialysis patients. Lung B-line score, IVC parameters, and BIS may be complementary to each other and to clinical data. Lung B-lines outperform IVC measurements and BIS in subclinical volume overload detection in pediatric hemodialysis patients. Graphical abstract

show abstract

Lung ultrasound and bioimpedance in assessment of volume status of hemodialysis patients

Cited by 4 publications

References 0 publications

Utility of Bedside Lung Ultrasound in the Assessment of Volume Status in Patients on Chronic Haemodialysis

Utility of Bedside Lung Ultrasound in the Assessment of Volume Status in Patients on Chronic Haemodialysis

Use of Bioimpedance in Pediatrics

Assessment of volume status of pediatric hemodialysis patients

Contact Info

Product

Resources

About