Affiliation:
1. Faculty of Medicine Cairo University Cairo Egypt
2. Faculty of Medicine Ain‐Shams University Cairo Egypt
3. Hamidiye International School of Medicine University of Health Sciences Istanbul Turkey
4. Nephrology Unit, Internal Medicine Department Assiut University Assiut Egypt
5. Department of Internal Medicine II University Hospital Giessen and Marburg Giessen Germany
6. Department of Nephrology, Dialysis and Transplantation International Renal Research Institute of Vicenza, San Bortolo Hospital Vicenza Italy
7. Transplantation Immunology, Institute of Immunology University Hospital Heidelberg Germany
8. Department of Nephrology University Hospital Heidelberg Heidelberg Germany
Abstract
AbstractRationale 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.