Abstract: SA-PO748

Study of Lung Ultrasound as a Sensitive Tool for Evaluating Fluid Status in Chronic Hemodialysis Patients

Session Information

Category: Dialysis

  • 601 Standard Hemodialysis for ESRD

Author

  • Elwakil, Hala S., U of Alexandria - Faculty of Medicine, Alexandria, Egypt

Group or Team Name

  • Hemodialysis lung comets group
Background

Control of fluid status is an important constituent of adequate and efficient hemodialysis treatment. Dry weight is usually assessed clinically, and several methods have been developed to assess the hydration status in chronic hemodialysis patients. Ultrasonographic lung comets evaluates extravascular lung water while the diameter of inferior vena cava (IVC) estimates central venous pressure, so ultrasound is considered as a useful tool to evaluate the hydration status of hemodialysis patients.
The present study was designed to use lung ultrasound to assess lung congestion before and after a dialysis session in correlation to clinical signs and symptoms and the achieved dry weight as well as IVC diameter in hemodialysis patients.

Methods

The present study included 25 patients on maintenance hemodialysis in Alexandria University Hospitals. All the patients were subjected to thorough history taking with special concern on grade of dyspnea and ultrafiltration volume, as well as clinical examination for signs of hypervolemia. Radiological examination including ultrasound lung comets score and diameter of hepatic portion of inferior vena cava (IVC) before and after dialysis session.

Results

The mean lung comets score before dialysis was 54.72±28.47 and decreased significantly after dialysis to 28.52±19.88 (p=0.000). There was a significant positive correlation between ultrafiltration volume and the absolute change of lung comets score (p=0.003) while there was no significant correlation between the ultrafiltration volume and the absolute change of IVC diameter (p=0.219). There was a significant correlation between lung comets score and grade of dyspnea before and after dialysis (p=0.037, 0.001 respectively). Furthermore lung comets were found in asymptomatic patients especially after dialysis. There was a significant positive correlation between the grade of lung comets and IVC diameter both before and after dialysis (p=0.004, 0.003) respectively.

Conclusion

Ultrasound lung comets score is a sensitive marker of lung congestion and even may precede the development of symptoms of lung congestion in hemodialysis patients. Moreover, lung comets score is highly correlated with ultrafiltration volume, thus, it could be used as a good marker for achieving dry weight in hemodialysis patients with more superiority over IVC diameter assessment.

Funding

  • Government Support - Non-U.S.