Abstract: TH-PO0877
Lung Ultrasonography and Cancer Antigen 125 (CA-125) for Cardiovascular Risk Stratification in Patients on Hemodialysis
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
- Claure-Del Granado, Rolando, Universidad Mayor de San Simon Facultad de Medicina, Cochabamba, Bolivia, Plurinational State of
- Oliva-Cadima, Leydi M., Universidad Mayor de San Simon Facultad de Medicina, Cochabamba, Bolivia, Plurinational State of
- Rodriguez Ferrufino, Sergio, Division of Nephrology, Hospital Obrero No 2 - Caja Nacional de Salud, Cochabamba, Bolivia, Plurinational State of
Background
Volume overload is common in maintenance hemodialysis (HD) and contributes to cardiovascular events. Lung ultrasound (LUS) quantifies pulmonary congestion, whereas CA-125 may reflect systemic/serosal congestion. We evaluated whether simplified LUS and CA-125 identify HD patients at higher cardiovascular risk.
Methods
Prospective observational cohort of adults receiving maintenance HD three times weekly at Hospital Obrero No. 2, Cochabamba, Bolivia. Predialysis LUS was performed weekly using a 4-zone protocol with B-line quantification. CA-125 was measured monthly and analyzed as log(CA-125). The primary outcome was major adverse cardiovascular events (MACE: myocardial infarction, stroke, acute heart failure hospitalization, or sustained arrhythmia requiring intervention) or all-cause mortality. This interim analysis includes follow-up through 11 weeks. Spearman correlation assessed the LUS–CA-125 relationship. Cox models estimated hazard ratios (HRs) per 1-SD increment; Poisson models assessed hospitalizations.
Results
Among 39 participants, mean age was 59.4±13.4 years, 51.3% were women, 46.2% had diabetes, and 33.3% had heart failure. Accumulated follow-up was 388 patient-weeks; median follow-up was 11 weeks. Participants with the primary outcome had higher baseline LUS than those without events (median 5.0 [IQR 5.0–8.5] vs 3.0 [0.8–5.0] B-lines) and higher CA-125 (78.0 [38.5–93.0] vs 6.5 [3.4–20.0] U/mL). LUS and CA-125 correlated at baseline (ρ=0.50, p=0.001), with stronger correlation between mean LUS during weeks 1–4 and month 1 CA-125 (ρ=0.69, p<0.001). During follow-up, 11 participants (28.2%) had MACE or death, including 7 MACE and 8 deaths; 12 total hospitalizations and 5 heart failure hospitalizations occurred. In adjusted Cox models, baseline LUS (HR 2.56; 95% CI 1.18–5.52; p=0.017; C-index 0.80) and log(CA-125) (HR 2.92; 95% CI 1.28–6.66; p=0.011; C-index 0.83) were associated with the primary outcome. In a combined model, log(CA-125) remained associated with risk (HR 2.36; 95% CI 1.02–5.44; p=0.045). Higher baseline LUS correlated with hospitalizations (ρ=0.44, p=0.005).
Conclusion
In this interim HD cohort, simplified LUS and CA-125 captured complementary dimensions of congestion and were associated with short-term MACE or death. These findings support LUS and CA-125 as feasible tools for volume assessment and cardiovascular risk stratification in HD.
Acknowledgment
We gratefully acknowledge the Hemodialysis Service and the Imaging Division of Hospital Obrero No. 2 – Caja Nacional de Salud, Cochabamba, Bolivia, for their support in the conduct of this study.