We found a match
Your institution may have rights to this item. Sign in to continue.
- Title
Finding covert fluid: methods for detecting volume overload in children on dialysis.
- Authors
Allinovi, Marco; Saleem, Moin; Burgess, Owen; Armstrong, Catherine; Hayes, Wesley
- Abstract
Background: Lung ultrasound is a novel technique for detecting generalized fluid overload in children and adults with end-stage renal disease (ESRD). Echocardiography and bioimpedance spectroscopy are established methods, albeit variably adopted in clinical practice. We compared the practicality and accuracy of lung ultrasound with current objective techniques for detecting fluid overload in children with ESRD. Methods: A prospective observational study was performed to compare lung ultrasound B-lines, echocardiographic measurement of inferior vena cava parameters and bioimpedance spectroscopy in the assessment of fluid overload in children with ESRD on dialysis. The utility of each technique in predicting fluid overload, based on short-term weight gain, was assessed. Multiple linear regression models to predict fluid overload by weight were explored. Results: A total of 22 fluid assessments were performed in 13 children (8 on peritoneal dialysis, 5 on haemodialysis) with a median age of 4.0 (range 0.8-14.0) years. A significant linear correlation was observed between the number of B-lines detected by lung ultrasound and fluid overload by weight ( r = 0.57, p = 0.005). A non-significant positive linear correlation was observed between fluid overload by weight and bioimpedance spectroscopy ( r = 0.43, p = 0.2), systolic blood pressure ( r = 0.19, p = 0.4) and physical examination measurements ( r = 0.19, p = 0.4), while a non-significant negative linear relationship was found between the inferior vena cava collapsibility index and fluid overload by weight ( r = −0.24, p = 0.3). In multiple linear regression models, a combination of three fluid parameters, namely lung ultrasound B-lines, clinical examination and systolic blood pressure, best predicted fluid overload ( R = 0.46, p = 0.05). Conclusions: Lung ultrasound may be superior to echocardiographic methods and bioimpedance spectroscopy in detecting volume overload in children with ESRD. Given the practicality and sensitivity of this new technique, it can be adopted alongside clinical examination and blood pressure in the routine assessment of fluid status in children with ESRD.
- Subjects
DIAGNOSIS of edema; EVALUATION of diagnostic imaging; BLOOD pressure measurement; CHI-squared test; ECHOCARDIOGRAPHY; HEMODIALYSIS patients; KIDNEY diseases; LONGITUDINAL method; PROBABILITY theory; REGRESSION analysis; SPECTRUM analysis; ULTRASONIC imaging; DISEASE complications; CHILDREN
- Publication
Pediatric Nephrology, 2016, Vol 31, Issue 12, p2327
- ISSN
0931-041X
- Publication type
Article
- DOI
10.1007/s00467-016-3431-4