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Concordance between bio-impedance analysis and clinical score in fluid-status assessment of maintenance haemodialysis patients: A single centre experience

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World Journal of Nephrology 2022年第4期11卷 127-138页

作者： Kamiti Muchiri Joshua K Kayima Elijah N Ogola Seth McLigeyo Sally W Ndung’u Samuel K Kabinga clinical Medicine and Therapeutics University of NairobiNairobi+254Kenya Department of clinical Medicine and Therapeutics University of NairobiNairobi+254Kenya Department of Public Health University of NairobiNairobi+254Kenya East African Kidney Institute University of NairobiNairobi+254Kenya

BACKGROUND The burden of chronic kidney disease(CKD)is rising rapidly *** overload(FO),an independent predictor of mortality in CKD,should be accurately assessed to guide estimation of the volume of fluid to be removed during haemodialysis(HD).clinical score(CS)and bio-impedance analysis(BIA)have been utilized in assessment of FO and BIA has demonstrated reproducibility and accuracy in determination of fluid status in patients on *** is need to determine the performance of locally-developed CSs in fluid status assessment when evaluated against *** To assess the hydration status of patients on maintenance HD using BIA and a CS,as well as to evaluate the performance of that CS against BIA in fluid status *** This was a single-centre,hospital-based cross-sectional study which recruited adult patients with CKD who were on maintenance HD at Kenyatta National *** patients were aged 18 years and above and had been on maintenance HD for at least 3 *** with pacemakers,metallic implants,or bilateral limbs amputations were *** on the patients’clinical history,physical examination,and chest radiograph findings were *** was performed on each of the study participants using the Quantum®II bio-impedance analyser manufactured by RJL Systems together with the BC 4®*** evaluating the performance of the CS,BIA was considered as the gold standard test.A 2-by-2 table of the participants’fluid status at each of the CS values obtained compared to their paired BIA results was constructed(either++,+-,--or-+for FO using the CS and BIA,respectively).The results from this 2-by-2 table were used to compute the sensitivity and specificity of the CS at the various reference points and subsequently plot a receiver operating characteristic(ROC)curve that was used to determine the best cut-off *** above and below the best CS cut-off point as determined by the ROC were classified as being positive and negative for FO

关键词： Bio-impedance analysis clinical score Chronic kidney disease Maintenance haemodialysis Fluid overload Concordance

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Role of Lung Ultrasound in the Assessment of Hydration Status of Chronic Haemodialysis Patients

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Open Journal of Radiology 2023年第1期13卷 1-16页

作者： Sylviane Fomekong Dongmo Jean-Roger Tapouh Moulion Denis Georges Teuwafeu Samory Guedje Chuangueu François Jérôme Folefack Kaze Boniface Moifo Department of Internal Medicine and Paediatrics Faculty of Health Sciences University of Buea Buea Cameroon Department of Radiology Faculty of Medicine and Pharmaceutical Sciences University of Dschang Dschang Cameroon Department of Internal Medicine and Specialties Faculty of Medicine and Biomedical Sciences University of Yaoundé 1 Yaoundé Cameroon Department of Radiology and Medical Imaging Faculty of Medicine and Biomedical Sciences University of Yaoundé 1 Yaoundé Cameroon

Background: Fluid overload is frequent in Haemodialysis (HD) and is one of the major factors of cardiovascular morbidity and mortality for chronic HD patients. The main challenge with chronic haemodialysis patients is indeed the maintenance of a normal extracellular volume through dry weight determination. Our study aimed at assessing the role of lung ultrasound in the detection of B-lines for the determination of hydration status in chronic HD patients. Methods: We conducted a cross-sectional study including 31 patients undergoing chronic HD treatment for at least 3 months, in the Yaounde University Teaching Hospital dialysis unit. Lung ultrasonography and clinical examinations were performed immediately before dialysis, and 30 minutes after dialysis. Differences between clinical and ultrasound variables before and after dialysis were measured to assess the effects of dialysis. Association between categorical variables was assessed with the Chi-squared test or Fischer test, and Rho’s Spearman coefficient for quantitative variables. Results: There was a reduction in the median of B-lines score after dialysis [12 (7 - 26) versus 8 (5 - 13)], clinical score [2 (1 - 3) versus 0 (-1 - 2)], mean of systolic blood pressure (164.74 ± 26.50 versus 158.48 ± 27.89), frequency of dyspnoea in patients (32.3% versus 6.5%);and raising of the frequency of cramps in patients (0% versus 19.4%) and all statistically significant (p ≤ 0.031). B-lines score before and after dialysis was associated with dyspnoea and raised jugular venous pressure (p Conclusion: Lung ultrasound for the detection of B-lines reflects the variation of extracellular volume during dialysis and can even capture pulmonary oedema at a pre-clinical stage. It is then a reliable and sensible method for assessing extravascular lung water and thus hydration status of haemodialysis patients. It could constitute a better alternative for an objective and accurate definition of dry weight, specifically in the African and

关键词： Haemodialysis Lung Ultrasound B-Lines Hydration Status clinical score

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