Kidney Week

Abstract: TH-PO0882

Ultrasound Markers of Fluid Overload in Patients on Hemodialysis Compared with Bioimpedance Spectroscopy

Session Information

• Dialysis: Prescription, Physiology, and Treatment Optimization
  October 22, 2026 | Location: Exhibit Hall A, Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Dialysis

• 801 Dialysis: Hemodialysis and Frequent Dialysis

Authors

• Arizaga Napoles, Manuel, Hospital Civil de Guadalajara, Guadalajara, Jal., Mexico

Manuel Arizaga Napoles, MD

• Chavez, Jonathan, Hospital Civil de Guadalajara, Guadalajara, Jal., Mexico

Jonathan Chavez, MD, PhD

• Cruz Aragon, Fernando, Hospital Civil de Guadalajara, Guadalajara, Jal., Mexico

Fernando Cruz Aragon, MD

• De la Torre De la Vega, Ixchel, Universidad de Guadalajara, Guadalajara, Jal., Mexico

Ixchel De la Torre De la Vega, MD

• Martínez Aguilar, Alma Isela, Universidad de Guadalajara, Guadalajara, Jal., Mexico

Alma Isela Martínez Aguilar, MD

• Tanaka-Gutiérrez, Jarumi Andrea, Universidad de Guadalajara, Guadalajara, Jal., Mexico

Jarumi Andrea Tanaka-Gutiérrez

• Medina, Ramon, Hospital Civil de Guadalajara, Guadalajara, Jal., Mexico

Ramon Medina, MD

• Alcantar Vallin, Maria de la Luz, Hospital Civil de Guadalajara, Guadalajara, Jal., Mexico

Maria de la Luz Alcantar Vallin, MD

• Martínez Gallardo González, Alejandro, Hospital Civil de Guadalajara, Guadalajara, Jal., Mexico

Alejandro Martínez Gallardo González

• Mendoza Gaitán, Héctor Eduardo, Hospital Civil de Guadalajara, Guadalajara, Jal., Mexico

Héctor Eduardo Mendoza Gaitán, MD

• Renoirte, Karina, Hospital Civil de Guadalajara, Guadalajara, Jal., Mexico

Karina Renoirte, PhD

• Abundis Mora, Gabriela Jazmín, Hospital Civil de Guadalajara, Guadalajara, Jal., Mexico

Gabriela Jazmín Abundis Mora, MD

• Navarro Blackaller, Guillermo, Hospital Civil de Guadalajara, Guadalajara, Jal., Mexico

Guillermo Navarro Blackaller, MD

• Gómez, Juan Alberto, Hospital Civil de Guadalajara, Guadalajara, Jal., Mexico

Juan Alberto Gómez, MD

Background

Fluid overload (FO) in hemodialysis (HD) patients associates to increased mortality. Bioimpedance spectroscopy (BIS) is an objective method to detect FO and is used in many parts of the world. Ultrasound imaging of lungs (LUS) and inferior vena cava diameter (IVCD) for the detection of FO has also been proposed for the diagnosis of FO. We investigated diagnostic performance of FO by use of LUS, IVCD, in reference to results obtained by BIS.

Methods

We included prevalent HD patients in this cross-sectional study and analyzed the association between FO diagnosed by clinical assessment, BIS, LUS by assessment of B-lines, and IVCD; evaluated diagnostic performance with different cut-offs, and further investigated the association of intradialytic changes of the markers with ultrafiltration (UF) volume removed.

Results

We studied 78 patients (age 37+/-SD, 41% female, 65% with FO as per BCM) between 2022 and 2023. A lower number of B-lines number had fewer frequency of FO, and defining a cutoff of ≥2 B lines as being fluid overloaded, had a sensitivity of 90% (CI 82-98%), and a specificity of 75% (CI 64-86%), a positive predictive value 56% (CI 42-70%), and the negative predictive value of 93% (CI 80-100%) in diagnosing FO as defined by BCM. Defining a IVCD of 1.75 cm as fluid overloaded resulted in an AUC of 0.84. Both LUS score and IVCD, correlated with the UF volume with a correlation coefficient of 0.91. I would suggest a uniform presentation of diagnostic performance. I.e. ROC AUC for IVCD and US

Conclusion

While differences in diagnostic performance were observed, the use of handheld ultrasound devices allowed by assessment of LUS and IVCD to diagnose FO.