Lung Ultrasound and Caval Indices to Assess Volume Status in Maintenance Hemodialysis Patients
Background: Volume overload is common in end stage kidney disease (ESKD) and dialysis patients. Hence, the need for objective tools to detect such volume excess. Point of care ultrasound (POCUS) is a goal-directed, bedside examination to answer such a specific diagnostic question. Methods: One hund...
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| Format: | Article |
| Language: | English |
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CINQUILL Medical Publishers Inc.
2023-04-01
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| Series: | POCUS Journal |
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| Online Access: | https://ojs.library.queensu.ca/index.php/pocus/article/view/15802 |
| _version_ | 1797838000152903680 |
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| author | Mujtaba Z. AL-Saray Ala Ali |
| author_facet | Mujtaba Z. AL-Saray Ala Ali |
| author_sort | Mujtaba Z. AL-Saray |
| collection | DOAJ |
| description |
Background: Volume overload is common in end stage kidney disease (ESKD) and dialysis patients. Hence, the need for objective tools to detect such volume excess. Point of care ultrasound (POCUS) is a goal-directed, bedside examination to answer such a specific diagnostic question. Methods: One hundred Iraqi adult hemodialysis patients were recruited from February 1 to May 31, 2022. Primary clinical, dialysis data, and prescriptions were recorded. A nephrologist performed a POCUS examination after the last dialysis session of the week. In addition, an ultrasound examination of the chest was performed to detect B-lines and pleural effusion. Caval parameters included inferior vena cava (IVC) diameter and collapsibility index. Results: The mean age of the study group was 51.48 ± 14.6 years, with 53% males. The mean interdialytic weight gain was 2.74 ± 1.15 Kg. Lower limb edema and pleural effusion were present in 33% and 27%, respectively. Forty-seven percent of patients had >3 B-lines on lung ultrasound with a range of 12. Forty-three percent of patients had an IVC diameter of >2 cm, and 93% had <50% IVC collapsibility. In total, 97% of patients had evidence of excess volume by ultrasound criteria. IVC collapsibility index was the most prevalent sign of excess volume (93%). Patients without lower limb edema and pleural effusion had positive B-lines in 38.8% and 38.3%, an IVC diameter >2 cm in 46.2% and 38.3%, and IVC collapsibility <50% in 89.5% and 95.8% respectively. Conclusion: Iraqi maintenance hemodialysis patients are volume overloaded, which warrants proper intervention for detection and dialysis management. POCUS is a useful and easily performed technique to assess the volume status.
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| first_indexed | 2024-04-09T15:33:41Z |
| format | Article |
| id | doaj.art-c20e200cd5a64064b2e0e5287f8c809b |
| institution | Directory Open Access Journal |
| issn | 2369-8543 |
| language | English |
| last_indexed | 2024-04-09T15:33:41Z |
| publishDate | 2023-04-01 |
| publisher | CINQUILL Medical Publishers Inc. |
| record_format | Article |
| series | POCUS Journal |
| spelling | doaj.art-c20e200cd5a64064b2e0e5287f8c809b2023-04-28T04:00:08ZengCINQUILL Medical Publishers Inc.POCUS Journal2369-85432023-04-018110.24908/pocus.v8i1.15802Lung Ultrasound and Caval Indices to Assess Volume Status in Maintenance Hemodialysis PatientsMujtaba Z. AL-Saray0Ala Ali1Nephrology and Renal Transplantation Centre, The Medical City, Baghdad, IraqNephrology and Renal Transplantation Centre, The Medical City, Baghdad, Iraq Background: Volume overload is common in end stage kidney disease (ESKD) and dialysis patients. Hence, the need for objective tools to detect such volume excess. Point of care ultrasound (POCUS) is a goal-directed, bedside examination to answer such a specific diagnostic question. Methods: One hundred Iraqi adult hemodialysis patients were recruited from February 1 to May 31, 2022. Primary clinical, dialysis data, and prescriptions were recorded. A nephrologist performed a POCUS examination after the last dialysis session of the week. In addition, an ultrasound examination of the chest was performed to detect B-lines and pleural effusion. Caval parameters included inferior vena cava (IVC) diameter and collapsibility index. Results: The mean age of the study group was 51.48 ± 14.6 years, with 53% males. The mean interdialytic weight gain was 2.74 ± 1.15 Kg. Lower limb edema and pleural effusion were present in 33% and 27%, respectively. Forty-seven percent of patients had >3 B-lines on lung ultrasound with a range of 12. Forty-three percent of patients had an IVC diameter of >2 cm, and 93% had <50% IVC collapsibility. In total, 97% of patients had evidence of excess volume by ultrasound criteria. IVC collapsibility index was the most prevalent sign of excess volume (93%). Patients without lower limb edema and pleural effusion had positive B-lines in 38.8% and 38.3%, an IVC diameter >2 cm in 46.2% and 38.3%, and IVC collapsibility <50% in 89.5% and 95.8% respectively. Conclusion: Iraqi maintenance hemodialysis patients are volume overloaded, which warrants proper intervention for detection and dialysis management. POCUS is a useful and easily performed technique to assess the volume status. https://ojs.library.queensu.ca/index.php/pocus/article/view/15802HemodialysisIraqLungPOCUSVolume |
| spellingShingle | Mujtaba Z. AL-Saray Ala Ali Lung Ultrasound and Caval Indices to Assess Volume Status in Maintenance Hemodialysis Patients POCUS Journal Hemodialysis Iraq Lung POCUS Volume |
| title | Lung Ultrasound and Caval Indices to Assess Volume Status in Maintenance Hemodialysis Patients |
| title_full | Lung Ultrasound and Caval Indices to Assess Volume Status in Maintenance Hemodialysis Patients |
| title_fullStr | Lung Ultrasound and Caval Indices to Assess Volume Status in Maintenance Hemodialysis Patients |
| title_full_unstemmed | Lung Ultrasound and Caval Indices to Assess Volume Status in Maintenance Hemodialysis Patients |
| title_short | Lung Ultrasound and Caval Indices to Assess Volume Status in Maintenance Hemodialysis Patients |
| title_sort | lung ultrasound and caval indices to assess volume status in maintenance hemodialysis patients |
| topic | Hemodialysis Iraq Lung POCUS Volume |
| url | https://ojs.library.queensu.ca/index.php/pocus/article/view/15802 |
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