The use of lung ultrasound in evaluation of extravascular lung water in hemodialysis patients: Systematic review and meta-analysis.

Autor: Elgenidy A; Faculty of Medicine, Cairo University, Cairo, Egypt., Amin MA; Faculty of Medicine, Cairo University, Cairo, Egypt., Awad AK; Faculty of Medicine, Ain-Shams University, Cairo, Egypt., Emad A; Faculty of Medicine, Cairo University, Cairo, Egypt., Nassar A; Faculty of Medicine, Cairo University, Cairo, Egypt., Alomari O; Hamidiye International School of Medicine, University of Health Sciences, Istanbul, Turkey., Ibrahim R; Nephrology Unit, Internal Medicine Department, Assiut University, Assiut, Egypt., Husain-Syed F; Department of Internal Medicine II, University Hospital Giessen and Marburg, Giessen, Germany.; Department of Nephrology, Dialysis and Transplantation, International Renal Research Institute of Vicenza, San Bortolo Hospital, Vicenza, Italy., Aly MG; Nephrology Unit, Internal Medicine Department, Assiut University, Assiut, Egypt.; Transplantation Immunology, Institute of Immunology, University Hospital, Heidelberg, Germany.; Department of Nephrology, University Hospital Heidelberg, Heidelberg, Germany.
Jazyk: angličtina
Zdroj: Hemodialysis international. International Symposium on Home Hemodialysis [Hemodial Int] 2024 Apr; Vol. 28 (2), pp. 148-161. Date of Electronic Publication: 2024 Feb 27.
DOI: 10.1111/hdi.13141
Abstrakt: Rationale and Objectives: Determining dry weight is crucial for optimizing hemodialysis, influencing efficacy, cardiovascular outcomes, and overall survival. Traditional clinical assessment methods for dry weight, relying on factors such as blood pressure and edema, frequently lack reliability. Lung ultrasound stands out as a promising tool for assessing volume status, given its non-invasiveness and reproducibility. This study aims to explore the role of Lung ultrasound in evaluating the impact of hemodialysis and ultrafiltration on extravascular lung water, with a specific focus on changes in B-lines post-hemodialysis compared to pre-hemodialysis.
Materials and Methods: The research encompassed searches across PubMed, WOS, and Scopus databases for studies related to lung ultrasound and hemodialysis. A meta-analysis was then performed to determine the mean differences in various parameters before compared to after, hemodialysis, including the number of B-lines, indexed end-inspiratory and end-expiratory inferior vena cava diameters, inferior vena cava collapsibility index, weight, blood pressure, and serum levels of NT-pro-BNP.
Results: Our meta-analysis, included 33 studies with 2301 hemodialysis patients, revealed a significant decrease in the number of B-lines post-hemodialysis (mean difference = 8.30, 95% CI [3.55 to 13.05]). Furthermore, there was a noteworthy reduction in inspiratory and expiratory inferior vena cava diameters post-hemodialysis (mean difference = 2.32, 95% CI [0.31 to 4.33]; mean difference = 4.05, 95% CI [2.44 to 5.65], respectively). Additionally, a significant positive correlation was observed between B-lines and the maximum inferior vena cava diameter both pre- and post-hemodialysis (correlation coefficient = 0.39; correlation coefficient = 0.32, respectively).
Conclusion: These findings indicate the effectiveness of lung ultrasound in detection of volume overload and assessment of response to ultrafiltration in hemodialysis patients.
(© 2024 International Society for Hemodialysis.)
Databáze: MEDLINE
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