Diagnostic Utility of Thoracic Ultrasound in Assessment of Volume Status of Haemodialysis Patients

Abstract

Background: Optimizing volume status of hemodialysis patients is an important clinical challenge because volume expansion is a critical deadly complication of chronic kidney disease. The use of thoracic ultrasound to detect cases of volume overload and depletion has gained great attention by several studies that are because of its advantage as a rapid, available, non-invasive and free of radiation imaging method. Aim: To evaluate the usefulness of thoracic ultrasound for the assessment of extravascular lung water and intravascular volume in hemodialysis patients. Patients and Methods: This prospective observational study was conducted on 30 patients on regular hemodialysis. Assessment of extravascular lung water (EVLW) by number of B –lines, and intravascular volume by measurement of inferior vena cava (IVC) diameter and collapsibility index, was done pre- and post-dialysis. Results: There was statistically highly significant reduction in number of B-lines and highly significant decrease of IVC minimum and maximum diameters post-dialysis (P value < 0.001). There was also highly significant increase in IVC collapse index following hemodialysis (P value < 0.001). Conclusion: Lung ultrasound is a useful method for the assessment of both EVLW and intravascular volume. EVLW as represented by B-lines number was highly significantly reduced post-hemodialysis. Intravascular volume assessed by IVC ultrasound was improved by 53% following hemodialysis.