Assessment of fluid removal using ultrasound, bioimpedance and anthropometry in pediatric dialysis: a pilot study.

Autor: Ehlayel AM; Division of Nephrology, Children's Hospital of New Orleans, 200 Henry Clay Ave, New Orleans, LA, 70118, USA. abdulla.ehlayel@lcmchealth.org., Okunowo O; Data Science & Biostatistics Unit, Department of Biomedical and Health Informatics, Children's Hospital of Philadelphia, Philadelphia, USA., Dutt M; Division of Nephrology, Children's Hospital of Philadelphia, Philadelphia, USA., Howarth K; Division of Nephrology, Children's Hospital of Philadelphia, Philadelphia, USA., Zemel BS; Division of Gastroenterology, Hepatology and Nutrition, Children's Hospital of Philadelphia, Philadelphia, USA.; Perelman School of Medicine, University of Pennsylvania, Philadelphia, USA., Poznick L; Department of Radiology, Children's Hospital of Philadelphia, Philadelphia, USA., Morgan X; Division of Nephrology, Children's Hospital of Philadelphia, Philadelphia, USA., Denburg MR; Division of Nephrology, Children's Hospital of Philadelphia, Philadelphia, USA.; Perelman School of Medicine, University of Pennsylvania, Philadelphia, USA., Copelovitch L; Division of Nephrology, Children's Hospital of Philadelphia, Philadelphia, USA.; Perelman School of Medicine, University of Pennsylvania, Philadelphia, USA., Back SJ; Perelman School of Medicine, University of Pennsylvania, Philadelphia, USA.; Department of Radiology, Children's Hospital of Philadelphia, Philadelphia, USA., Otero HJ; Perelman School of Medicine, University of Pennsylvania, Philadelphia, USA.; Department of Radiology, Children's Hospital of Philadelphia, Philadelphia, USA., Hartung EA; Division of Nephrology, Children's Hospital of Philadelphia, Philadelphia, USA.; Perelman School of Medicine, University of Pennsylvania, Philadelphia, USA.
Jazyk: angličtina
Zdroj: BMC nephrology [BMC Nephrol] 2023 Jan 05; Vol. 24 (1), pp. 5. Date of Electronic Publication: 2023 Jan 05.
DOI: 10.1186/s12882-022-03012-1
Abstrakt: Background: Fluid overload is associated with morbidity and mortality in children receiving dialysis. Accurate clinical assessment is difficult, and using deuterium oxide (D 2 O) to measure total body water (TBW) is impractical. We investigated the use of ultrasound (US), bioimpedance spectroscopy (BIS), and anthropometry to assess fluid removal in children receiving maintenance hemodialysis (HD).
Methods: Participants completed US, BIS, and anthropometry immediately before and 1-2 h after HD for up to five sessions. US measured inferior vena cava (IVC) diameter, lung B-lines, muscle elastography, and dermal thickness. BIS measured the volume of extracellular (ECF) and intracellular (ICF) fluid. Anthropometry included mid-upper arm, calf and ankle circumferences, and triceps skinfold thickness. D 2 O was performed once pre-HD. We assessed the change in study measures pre- versus post-HD, and the correlation of change in study measures with percent change in body weight (%∆BW). We also assessed the agreement between TBW measured by BIS and D 2 O.
Results: Eight participants aged 3.4-18.5 years were enrolled. Comparison of pre- and post-HD measures showed significant decrease in IVC diameters, lung B-lines, dermal thickness, BIS %ECF, mid-upper arm circumference, ankle, and calf circumference. Repeated measures correlation showed significant relationships between %∆BW and changes in BIS ECF (r rm =0.51, 95% CI 0.04, 0.80) and calf circumference (r rm =0.80, 95% CI 0.51, 0.92). BIS TBW correlated with D 2 O TBW but overestimated TBW by 2.2 L (95% LOA, -4.75 to 0.42).
Conclusion: BIS and calf circumference may be helpful to assess changes in fluid status in children receiving maintenance HD. IVC diameter, lung B-lines and dermal thickness are potential candidates for future studies.
(© 2023. The Author(s).)
Databáze: MEDLINE
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