Use of Lung Ultrasound with Tissue Doppler Echocardiography to Follow up Cardiovascular State of Haemodialysis Patient

Abstract

Background: Chronic hypervolemia is the main cause of cardiovascular complications in haemodialysis patients. Objectives: We aimed to study the effect of lung ultrasound-guided dry weight reduction strategy on the cardiovascular state of hypertensive haemodialysis patients. Patients and Methods: We carried out a single-blind two-arm randomized trial on 50 hypertensive haemodialysis patients in Qena University Hospital dialysis centre over 8 weeks from 1/11/2020 to 1/1/2021. Patients were divided into usual care group (control arm) and active group(study arm). In study group, dry weight reduction was assessed weekly by lung ultrasonography guided by the total number of B-lines, before the midweek session ofhaemodialysis. In the controlgroup, dry weight probing was done according to clinical criteria. To assess outcomes,we compared the clinical and echocardiographic improvement in both groups including full clinical assessment, etc at baseline and at the study end. Results: In study group, dry weight wassignificantly reduced in comparison with the control group (−0.41 ± 0.32 vs. 0.04 ± 0.09 kg; P < 0.001), resulting in a statistically significant reduction in systolic and diastolic blood pressures (P < 0.001). Furthermore, a statistically significant reduction in echocardiographic indices of cardiac chambers dimensions occurred in study group,in addition to improvement of the diastolic function of both ventricles. Conclusion: Ultrafiltration based on assessment of fluid status using lung ultrasound dry weight reduction is better than that based on conventional method regarding both clinical and echocardiographic parameters.