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Abstract: PO1267

Lung Comets and Hydration Status in Peritoneal Dialysis Patients

Session Information

Category: Dialysis

  • 703 Dialysis: Peritoneal Dialysis

Authors

  • Ekart, Robert, University Medical Center Maribor, Maribor, Slovenia
  • Lucic Srajer, Lucijan, Medical Faculty University of Maribor, Maribor, Slovenia
  • Marko, Katharina, Medical Faculty University of Maribor, Maribor, Slovenia
  • Vodošek Hojs, Nina, University Medical Center Maribor, Maribor, Slovenia
  • Bevc, Sebastjan, University Medical Center Maribor, Maribor, Slovenia
  • Hojs, Radovan, University Medical Center Maribor, Maribor, Slovenia
Background

Multiple diagnostic options to determine hydration status in peritoneal dialysis (PD) patients are available. Multifrequency bioimpedance spectroscopy (MBIS) is a non-invasive method of estimating body composition,including total body water (TBW), extracellular water (ECW), intracellular water (ICW) and the ratio between both spaces (ECW/ICW). Lung ultrasonography (LUS) and lung B-lines (lung comets) can be used for the evaluation of extravascular lung water. Ultrasound evaluation of inferior vena cava (UIVC) provides a non-invasive assessment of a patient's hemodynamic and volume status. N-terminal pro-brain natriuretic peptide (NT-proBNP) is related to fluid status and fluid distribution. The aim of our study was to assess fluid status in PD patients comparing four different methods: MBIS,LUS,UIVC and NT-proBNP.

Methods

We performed a single-centre cohort study in 19 PD patients. The body composition was measured using the portable whole-body MBIS device, BCM(®)(Fresenius Medical Care,Germany), LUS with portable US device (VScan,GE Corporate),UIVC index with SonoSite US device. NT-proBNP was measured in a one-step sandwich chemiluminescent immunoassay (Siemens Healthcare Diagnostics,Newark,USA).

Results

The mean age of patients was 54±10 years, mean dialysis vintage 53 (10-194) months, 63% were men. Thirteen (68.4%) patients had fluid overload (FO)>1.1 L. Data of patients are presented in table 1. We found a statistically significant correlation between the number of lung comets and ECW/ICW ratio (r=0.496, P=0.031) and NT-proBNP (r=0.759, P<0.0001). In contrast, there was no significant correlation between the number of lung comets and UIVC (r=0.221, P<0.364).

Conclusion

According to our results, LUS with lung comets, MBIS with ECW/ICW ratio and NT-proBNP are useful and complementary methods for evaluation of fluid status in PD patients.

Descriptive data of the patients included in the study (N=19)
VariableMean ± SD
Lung comets (number;mean±SD)1-87; 16±21
UIVC (mm/m2,mean±SD)8.11±1.76
NT-proBNP (pmol/L)1151±1077
MBIS: Total body water (L)43.1±10.3
MBIS: Extracellular water (ECW) (L)20.3±5
MBIS: Intracellular water (ICW) (L)22.8±6.1
MBIS: ECW/ICW0.9±0.14
MBIS: Overhydration (L)2.45±3.05