Abstract: FR-PO849

Assessment of Pulmonary Congestion by thoracic Fluid Content Predicts Mortality in Hemodialysis Patients

Session Information

Category: Dialysis

  • 606 Dialysis: Epidemiology, Outcomes, Clinical Trials - Cardiovascular

Authors

  • Wu, Jining, Second Affiliated Hospital, Nanjing Medical University, Nanjing, China
  • Ye, Hong, Second Affiliated Hospital, Nanjing Medical University, Nanjing, China
  • Yang, Junwei, Second Affiliated Hospital, Nanjing Medical University, Nanjing, China
Background

Pulmonary congestion is prevalent and usually asymotomatic in patients with end-stage renal disease (ESRD). Thoracic fluid content (TFC) measured by thoracic electrical bioimpedance (TEB) is suggested to serve as a non-invasive measure of pulmonary congestion. We explored the clinical and echocadiographic correlates of thoracic fluid content as well as its prognostic value in hemodialysis patients.

Methods

In this prospective observational study, we enrolled 114 patients from a single hemodialysis unit. We used different methods of evaluation: thoracic bioimopedance (pre- and post-dialysis) and echocardiography (pre-dialysis). Our aim was to test the prognostic value of TFC in this population. Mortality was analysed after a median of 560.5-day follow-up. The primary outcome was all-cause death.

Results

TEB examination were successfully completed in 114 patients. Patients were divided into two categories based on the TFC measured before dialysis. TFC was strongly associated with left atrial diameter(LAD)(r=0.454,P=0.001), left ventricular posterior wall thickness (LVPW) (r=0.473,P=0.001)and ejection fraction (EF) (r=-0.527,P=0.001). After a median follow-up of 520-day, compaired with those patients having lower TFC, patients with higher TFC had 4.95–fold risk of death.

Conclusion

TEB is a technique that could detect pulmonary congestion at a pre-clinical stage in hemodialysis patients, and TFC emerged as a predictor for the mortality in this population.

Funding

  • Government Support - Non-U.S.