Lung Ultrasound–Guided Dry Weight Assessment and Echocardiographic Measures in Hypertensive Hemodialysis Patients: A Randomized Controlled Study

Loutradis, Charalampos; Papadopoulos, Christodoulos; Sachpekidis, V.; Ekart, Robert; Krunić, Barbara; Καρπέτας, Αντώνιος; Bikos, Athanasios; Tsouchnikas, Ioannis; Mitsopoulos, Efstathios; Papagianni, Αikaterini; Zoccali, Carmine; Sarafidis, Pantelis A.

doi:10.1053/j.ajkd.2019.07.025

Cited by 49 publications

(42 citation statements)

References 34 publications

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“…Moreover, at 8 weeks, the magnitude of 48-h ambulatory blood pressure reduction was significantly greater in the active group (systolic -6.61 vs. -0.67 mm Hg and diastolic -3.85 vs. -0.55, p = 0.033). Furthermore, the active group demonstrated a significant reduction in left ventricular filling pressures at 8 weeks [14].…”

Section: What Is the Benefit Of Lus-guided Dry Weight Adjustment?mentioning

confidence: 92%

The Promising Role of Lung Ultrasound in Assessment of Volume Status for Patients Receiving Maintenance Renal Replacement Therapy

2020

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Section: What Is the Benefit Of Lus-guided Dry Weight Adjustment?mentioning

confidence: 92%

The Promising Role of Lung Ultrasound in Assessment of Volume Status for Patients Receiving Maintenance Renal Replacement Therapy

2020

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“…One study showed a significantly lower rate of hospitalizations in the intervention group (Bajraktari 2018). Three studies did not show a significant difference (Siriopol 2017;Rivas 2019;Loutradis 2020).…”

Section: Hospitalizationsmentioning

confidence: 93%

“…All of seven studies showed more fluid removal in the intervention group (Wang 2014;Siriopol 2017;Ohman 2018;Wang 2018;Liang 2019;Pontet 2019;Loutradis 2020).…”

Section: Fluid Balancementioning

confidence: 99%

Effects of Lung Ultrasonography-Guided Management on Cumulative Fluid Balance and Other Clinical Outcomes: A Systematic Review

Heldeweg

Jagesar

Haaksma

et al. 2021

Ultrasound in Medicine & Biology

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Lung ultrasonography is accurate in detecting pulmonary edema and overcomes most limitations of traditional diagnostic modalities. Whether use of lung ultrasonography-guided management has an effect on cumulative fluid balances and other clinical outcomes remains unclear. In this systematic review, we included 12 studies using ultrasonography guided-management with a total of 2290 patients. Four in-patient studies found a reduced cumulative fluid balance (ranging from À0.3 L to À2.4 L), whereas three out-patient studies found reduction in dialysis dry weight (ranging from À2.6 kg to À0.2 kg) compared with conventionally managed patients. None of the studies found adverse effects related to hypoperfusion. The use of lung ultrasonographyguided management was not associated with other clinical outcomes. This systematic review shows that lung ultrasonography-guided management, exclusively or in concert with other diagnostic modalities, is associated with a reduced cumulative fluid balance. Studies thus far have not shown a consistent effect on clinical outcomes.

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“…Of note, in prospective cohort study of Zoccali et al [103], they showed that the number of lung comets can be a strong, independent predictor of mortality and cardiac events in HD patients. Moreover, a recent randomized sub-study of the ongoing Lung Water by Ultra Sound Guided Treatment to Prevent Death and Cardiovascular Complications in High Risk ESRD Patients with Cardiomyopathy Trial compared the effect of gradual dry-weight reduction with a lung US-guided strategy and standard-of-care approach on ambulatory BP in 71 hypertensive HD patients and showed significant reductions of 6.6/3.8 mm Hg in 48-h SBP [104], along with decreases in left and right atria dimensions and LV filling pressures [105].…”

Section: Lung Usmentioning

confidence: 99%

Assessment of Hydration Status in Peritoneal Dialysis Patients: Validity, Prognostic Value, Strengths, and Limitations of Available Techniques

2020

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Background: The majority of patients undergoing peritoneal dialysis (PD) suffer from volume overload and this overhydration is associated with increased mortality. Thus, optimal assessment of volume status in PD is an issue of paramount importance. Patient symptoms and physical signs are often unreliable indexes of true hydration status. Summary: Over the past decades, a quest for a valid, reproducible, and easily applicable technique to assess hydration status is taking place. Among existing techniques, inferior vena cava diameter measurements with echocardiography and natriuretic peptides such as brain natriuretic peptide and N-terminal pro-B-type natriuretic peptide were not extensively examined in PD populations; while having certain advantages, their interpretation are complicated by the underlying cardiac status and are not widely available. Bioelectrical impedance analysis (BIA) techniques are the most studied tool assessing volume overload in PD. Volume overload assessed with BIA has been associated with technique failure and increased mortality in observational studies, but the results of randomized trials on the value of BIA-based strategies to improve volume-related outcomes are contradictory. Lung ultrasound (US) is a recent technique with the ability to identify volume excess in the critical lung area. Preliminary evidence in PD showed that B-lines from lung US correlate with echocardiographic parameters but not with BIA measurements. This review presents the methods currently used to assess fluid status in PD patients and discusses existing data on their validity, applicability, limitations, and associations with intermediate and hard outcomes in this population. Key Message: No method has proved its value as an intervening tool affecting cardiovascular events, technique, and overall survival in PD patients. As BIA and lung US estimate fluid overload in different compartments of the body, they can be complementary tools for volume status assessment.

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Lung Ultrasound–Guided Dry Weight Assessment and Echocardiographic Measures in Hypertensive Hemodialysis Patients: A Randomized Controlled Study

Cited by 49 publications

References 34 publications

The Promising Role of Lung Ultrasound in Assessment of Volume Status for Patients Receiving Maintenance Renal Replacement Therapy

The Promising Role of Lung Ultrasound in Assessment of Volume Status for Patients Receiving Maintenance Renal Replacement Therapy

Effects of Lung Ultrasonography-Guided Management on Cumulative Fluid Balance and Other Clinical Outcomes: A Systematic Review

Assessment of Hydration Status in Peritoneal Dialysis Patients: Validity, Prognostic Value, Strengths, and Limitations of Available Techniques

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