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

Noor ul Ain; Naureen Akhtar; Shahida Perveen; Romaisa Sheikh; Muhammad Atif Anjum; Sahir Saud

doi:10.35787/jimdc.v13i(Suppl.).1202

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

DOI: https://doi.org/10.35787/jimdc.v13i(Suppl.).1202

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.