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Ekart R, Lucic Srajer L, Marko K, Hojs N, Bevc S, Hojs R. P1185LUNG COMETS AND EVALUATION OF HYDRATION STATUS IN PERITONEAL DIALYSIS PATIENTS. Nephrol Dial Transplant 2020. [DOI: 10.1093/ndt/gfaa142.p1185] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background and Aims
Assessment of optimal hydration status in patients with end-stage renal disease (ESRD) on peritoneal dialysis (PD) is a challenge. Multiple diagnostic options to determine hydration status in PD patients are available. Multifrequency bioimpedance spectroscopy (MBIS) is a cheap, simple and non-invasive method of estimating body composition, including estimates of total body water (TBW), extracellular water (ECW), intracellular water (ICW) and the ratio between both spaces (ECW/ICW). Lung ultrasonography (LUS) and lung B-lines (lung comets) can be used for the evaluation of extravascular lung water. Ultrasound evaluation of inferior vena cava (UIVC) provides rapid, non-invasive assessment of a patient's hemodynamic and volume status. N-terminal pro-brain natriuretic peptide (NT-proBNP) is related to fluid status and fluid distribution. The aim of our study was to assess fluid status in PD patients comparing four different methods: MBIS, LUS, UIVC and NT-proBNP.
Method
We performed a single-centre cohort study in 19 PD patients. The body composition was measured using the portable whole-body MBIS device, Body Composition Monitor-BCM(®) (Fresenius Medical Care, Bad Homburg, Germany), LUS with portable US device (VScan, General Electrics Corporate), UIVC index with SonoSite US device. NT-proBNP was measured in a one-step sandwich chemiluminescent immunoassay (Dimension Vista® System 1500, Siemens Healthcare Diagnostics Inc., Newark, NJ, USA).
Results
The mean age of patients was 54 ± 10 years, mean dialysis vintage 53 (10-194) months, 63% were men. Thirteen (68.4%) patients had fluid overload (FO) > 1.1 L. Data of patients are presented in table 1. We found a statistically significant correlation between the number of lung comets and ECW/ICW ratio (r = 0.496, P = 0.031) and NT-proBNP (r = 0.759, P < 0.0001). In contrast, there was no significant correlation between the number of lung comets and UIVC (r = 0.221, P < 0.364).
Conclusion
According to our results, LUS with lung comets, MBIS with ECW/ICW ratio and NT-proBNP are useful and complementary methods for evaluation of fluid status in PD patients.
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Affiliation(s)
- Robert Ekart
- UNIVERSITY MEDICAL CENTRE MARIBOR, CLINIC FOR INTERNAL MEDICINE, DEPT. OF DIALYSIS, MARIBOR, Slovenia
- UNIVERSITY OF MARIBOR, FACULTY OF MEDICINE, MARIBOR, Slovenia
| | | | - Katharina Marko
- UNIVERSITY OF MARIBOR, FACULTY OF MEDICINE, MARIBOR, Slovenia
| | - Nina Hojs
- UNIVERSITY MEDICAL CENTRE MARIBOR, CLINIC FOR INTERNAL MEDICINE, DEPT. OF NEPHROLOGY, MARIBOR, Slovenia
| | - Sebastjan Bevc
- UNIVERSITY OF MARIBOR, FACULTY OF MEDICINE, MARIBOR, Slovenia
- UNIVERSITY MEDICAL CENTRE MARIBOR, CLINIC FOR INTERNAL MEDICINE, DEPT. OF NEPHROLOGY, MARIBOR, Slovenia
| | - Radovan Hojs
- UNIVERSITY MEDICAL CENTRE MARIBOR, CLINIC FOR INTERNAL MEDICINE, DEPT. OF NEPHROLOGY, MARIBOR, Slovenia
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