Associations between fluid removal and number of B-lines, peak early mitral inflow wave velocity, and inferior vena cava dimensions in hemodialysis patients

Kimura, Kazuo; Kajimoto, Katsuya; Otsubo, Shigeru; Akiba, Takashi; Nitta, Kosaku

doi:10.1186/s41100-017-0141-8

Cited by 3 publications

(9 citation statements)

References 19 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…On the other hand, B-lines represent extravascular lung water. We previously reported that the IVC dimensions and the peak E-velocity were reduced mainly during the first half of the dialysis period, while the number of B-lines, which represents lung congestion, decreased significantly mainly during the last half of the dialysis period [18]. This finding may be largely dependent on the time lag in plasma refilling.…”

Section: Discussionmentioning

confidence: 89%

“…The decrease in oncotic pressure due to low serum level of albumin causes the movement of water from intravascular to lung interstitial. The malnutrition-inflammation-atherosclerosis syndrome affects mortality and hydration mechanics [18], which may be another cause of the relation between number of B-lines and mortality. The relationship between the number of B-lines and mortality has been reported by investigators in several countries.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Associations between pulmonary congestion on chest ultrasound and survival in hemodialysis patients

et al. 2019

Self Cite

View full text Add to dashboard Cite

Background: Volume overload in hemodialysis patients is an independent risk factor for cardiovascular eventrelated mortality. The number of B-lines observed using lung ultrasound is correlated with the severity of pulmonary congestion. The aim of this study was to evaluate the association between the number of B-lines and mortality among hemodialysis patients. Methods: A total of 61 patients receiving maintenance hemodialysis were enrolled in this study. Clinical data including age, sex, duration of hemodialysis therapy, presence of diabetes mellitus and/or hypertension and/or dyslipidemia complications, the results of biological examinations, and outcome were collected from the patients' clinical records. We performed echographic examinations at three time points (just after the start, during the middle, and just before the end of hemodialysis therapy). A univariate Cox proportional hazard model was used to identify predictors of the overall outcomes. Furthermore, we divided patients into two groups according to the median number of the B-lines at the end of dialysis and compared the mortality between the two groups. Results: The mean follow-up period was 507 ± 385 days. During the follow-up period, 24 deaths were recorded. Predictive variables for mortality included age; serum level of albumin, creatinine, and N-terminal pro-brain natriuretic peptide; and body weight (P < 0.001, P < 0.0001, P < 0.001, P = 0.014, and P = 0.019, respectively). The number of B-lines at the start, middle, and end of dialysis therapy was correlated with mortality (hazard ratio (95% confidence interval) 1.20 (1.09-1.32), P = 0.0002; 1.17 (1.07-1.28), P = 0.0008; and 1.23 (1.12-1.37), P = 0.0001; respectively). The mortality was statistically higher in the group with 5 or more B-lines than in the group with less than 5 B-lines (P = 0.013). Conclusions: The number of B-lines at the start, middle, and end of hemodialysis therapy may be correlated with mortality among hemodialysis patients.

show abstract

Section: Discussionmentioning

confidence: 89%

Section: Discussionmentioning

confidence: 99%

Associations between pulmonary congestion on chest ultrasound and survival in hemodialysis patients

et al. 2019

Self Cite

View full text Add to dashboard Cite

show abstract

“…On the other hand, B-lines represent extravascular lung water. We previously reported that the IVC dimensions and peak E-velocity decrease mainly during the first half of the dialysis session, while significant decrease in the number of B-lines, which reflects lung congestion, is observed mainly during the latter half of the dialysis session [18]. This finding may be largely dependent on the time lag in plasma refilling.…”

Section: Discussionmentioning

confidence: 90%

“…The chest wall was divided into 8 areas (2 anterior and 2 lateral areas per side), and each of these areas was scanned [16]. The number of B-lines was counted as described in a previous report [17][18][19]. A cardiologist, who is blind to the result of blood peripheral blood sample, performed echocardiography test.…”

Section: Methodsmentioning

confidence: 99%

Predicting factors of intradialytic hypotension in the last half of hemodialysis therapy

et al. 2021

Self Cite

View full text Add to dashboard Cite

Background Intradialytic hypotension (IDH) is one of the most frequent complications of hemodialysis. IDH alters a patient’s quality of life and has a strong association with mortality. IDH mainly occurs when ultrafiltration during hemodialysis exceeds the pace of the plasma refill. Ultrasonography has been used to evaluate the intravascular volume status. We evaluated the association between IDH and baseline laboratory data or ultrasound findings during IDH during the latter half of a hemodialysis session. Methods Sixty-two patients who underwent hemodialysis were enrolled in this study. The peak early mitral inflow wave velocity (peak E-velocity), the inferior vena cava (IVC) dimensions, and number of B-lines were estimated at two time points (just after the start and at the midpoint of the hemodialysis session). We compared the parameters between the patients without IDH throughout the hemodialysis session (non-IDH group) and patients with IDH only during the latter half of the hemodialysis session (IDH in the latter half group). Results Of the 62 study participants, 28 patients were in non-IDH group, and 16 patients were in IDH in the latter half group. The serum sodium level was significantly lower in the IDH in the latter half group (135 ± 4 mEq/L) than in the non-IDH group (138 ± 4 mEq/L) (P = 0.015). The rate of decrease of the peak E-velocity was significantly higher in the IDH in the latter half group (0.33 ± 0.13) than in the non-IDH group (0.24 ± 0.14) (P = 0.037). The best cutoff point of the serum level of sodium was 137 mEq/L, with a sensitivity of 68.8% and specificity of 64.3%. The area under the receiver operating characteristic (ROC) curve was 0.71. The best cutoff point of the rate of decrease of the peak E-velocity was 0.295, with a sensitivity of 73.3% and a specificity of 71.4%. The area under the ROC curve was 0.71. Conclusions A low serum level of sodium at baseline and an early decrease in the peak E-velocity during hemodialysis may be related to intradialytic hypotension in the latter half of a hemodialysis session. Careful observation may be needed in the hemodialysis patients in whom the serum level of sodium is below 137 mEq/L or the rate of decrease of the peak E-velocity is over 0.295.

show abstract

“…The meta-analysis incorporated 13 studies 6,7,18-28 of the included 33 studies, while the other 20 studies, lacking sufficient numerical data, were included for qualitative analysis as part of the systematic review. 9,[29][30][31][32][33][34][35][36][37][38][39][40][41][42][43][44][45][46][47]…”

Section: Study Selectionmentioning

confidence: 99%

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

Elgenidy,

Amin,

Awad

et al. 2024

Hemodialysis International

View full text Add to dashboard Cite

Rationale and ObjectivesDetermining 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 MethodsThe 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.ResultsOur 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).ConclusionThese findings indicate the effectiveness of lung ultrasound in detection of volume overload and assessment of response to ultrafiltration in hemodialysis patients.

show abstract

Associations between fluid removal and number of B-lines, peak early mitral inflow wave velocity, and inferior vena cava dimensions in hemodialysis patients

Cited by 3 publications

References 19 publications

Associations between pulmonary congestion on chest ultrasound and survival in hemodialysis patients

Associations between pulmonary congestion on chest ultrasound and survival in hemodialysis patients

Predicting factors of intradialytic hypotension in the last half of hemodialysis therapy

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

Contact Info

Product

Resources

About