Utilizing Integrated Lung and Inferior Vena Cava Ultrasound for Dry Weight Assessment - Insights from a Single-Center Experience

  • Noor ul Ain Children's Hospital and university of child health and sciences
  • Naureen Akhtar 1Department of Paediatric Nephrology Children's Hospital and University of Child Health Sciences Lahore
  • Shahida Perveen Department of Paediatric Nephrology, Children’s Hospital Lahore
  • Romaisa Sheikh 2Department of Paediatric Nephrology, Children’s Hospital Lahore
  • Muhammad Atif Anjum Department of Paediatric Nephrology, Children’s Hospital Lahore
  • Sahir Saud Department of Paediatric Nephrology, Children’s Hospital Lahore

Abstract

ABSTRACT

Precise dry weight evaluation holds significant importance for individuals with end-stage renal disease (ESRD) undergoing hemodialysis. Fluid overload is associated with an increased likelihood of mortality and morbidity. Ultrasonography aids in assessing dry weight and modifying dialysis prescription.

OBJECTIVE:

To assess the following in ESRD Patients by ultrasonography:

  • Dry weight and effectiveness of fluid removal
  • Adjust the dialysis prescription

METHODOLOGY:

A prospective cross-sectional study was carried out in the Pediatric Hemodialysis unit at The Children's Hospital Lahore, over 6 months from July to December 2022. The study included 30 children aged 5-16 years undergoing maintenance hemodialysis and exhibiting signs of overload. Ultrasound was performed for B-lines and IVC diameter before and after dialysis. Dialysis prescriptions were modified and patients were monitored through sequential scans. Data was analyzed using SPSS version 20.

RESULTS: A total of 30 patients were enrolled with 53.3% being males. The average pre-dialysis weight was 25.39 kg, systolic blood pressure was 150.67 mmHg and diastolic blood pressure was 92.6 mmHg. Pre-dialysis pleural and pericardial effusions were observed in 86.7%   patients, while B-lines were present in 63.3%. Majority of children (83%) were on twice-weekly dialysis and remaining were prescribed thrice weekly dialysis. A significant reduction in weight, blood pressure, pleural and pericardial effusion, B-lines, and IVC diameter was found after dialysis. Dialysis prescription was adjusted following the first session, with 80% subjects receiving thrice-weekly sessions, 16.7% daily, and 3.3% twice-weekly dialysis.

CONCLUSION: Monitoring the appropriate fluid removal and adjustments to the dialysis prescription in hemodialysis patients can be accomplished using ultrasonography.

Keywords:  Dry weight, Ultrasound, B-lines, IVC, Dialysis frequency.

Published
2024-11-18
Section
Original Articles