Abstract: FR-OR104
Lung Ultrasound B-Lines and Oxygen Status in Automated Peritoneal Dialysis Patients
Session Information
- Peritoneal Dialysis: Innovations and Clinical Practice
November 08, 2019 | Location: 147, Walter E. Washington Convention Center
Abstract Time: 05:06 PM - 05:18 PM
Category: Dialysis
- 703 Dialysis: Peritoneal Dialysis
Authors
- Argyropoulos, Christos, University of New Mexico, Albuquerque, New Mexico, United States
- Roumelioti, Maria-Eleni, University of New Mexico, Albuquerque, New Mexico, United States
- Xu, Zhi, University of New Mexico, Albuquerque, New Mexico, United States
- Pankratz, V. Shane, UNM Health Sciences Center, Albuquerque, New Mexico, United States
- Unruh, Mark L., University of New Mexico, Albuquerque, New Mexico, United States
Background
Patients undergoing automated PD (APD) are frequently fluid overloaded, while anuric dialysis patients with low fluid removal depict uncontrolled hypertension, LVH and worse survival. In this report, we aim to explore the correlation of overhydration (B-lines) as detected using lung ultrasound (LUS) in APD patients with their vital signs and weight.
Methods
Fourteen chronic APD patients were recruited at the Dialysis Clinic Inc. (DCI) PD center in Albuquerque, NM and completed their first visit of the pilot study LUMIFY-PD (Lung Ultrasonography to Measure Interstitial Fluid in Your Peritoneal Dialysis patients). Demographics, personal history, and laboratory values were collected from their electronic medical records. A pre-trained physician performed LUS with a handheld scanner (Phillips©Lumify, 2-5 MHz phased-array probe). Examination of the anterolateral chest was performed with longitudinal LUS scans (28 total sectors per exam, supine position). LUS exams were scored for the presence and number of B-lines.
Results
Study participants had a mean age of 41.5 (± 3.4) years and were mostly males (52.9%), whites (57.1%) and Hispanics (50%). They were on PD for a mean of 9.9 (± 7.3) months. The two main causes of kidney disease were DM and hypertension. 57% exhibited at least 1 B-line in their LUS while 21.4% had mild lung congestion (at least 3 B-lines) (Figure). All patients with detectable B-lines had normal physical exams. A statistically significant correlation was found between age and number of antihypertensives (p=0.05) as well as between number of B-lines in LUS and % of arterial oxygen saturation (p=0.002). A negative correlation was found between number of B-lines and residual renal function volume (Pearson correlation -0.65).
Conclusion
In this report the number of LUS B-lines correlated with oxygen saturation and residual renal function volume. Larger studies are needed. Portable LUS can optimize the assessment of prescribed “dry weight” and thus improve outcomes of incident APD patients.
A study participant with B-lines in lung ultrasound
Funding
- Other NIH Support