Sci Rep. 2026 Jan 23. doi: 10.1038/s41598-025-32769-2. Online ahead of print.
ABSTRACT
Patients with chronic kidney disease undergoing hemodialysis are at an increased risk of cardiovascular complications due to volume overload. Lung ultrasound (LUS) has emerged as a non-invasive tool to assess extravascular lung water (EVLW) and manage fluid excess. This study aimed to validate LUS in a relatively asymptomatic day-care dialysis population and to correlate it with clinical parameters, ECHO/IVC metrics. This prospective pre-post intervention study was conducted in a dialysis unit, enrolling 93 eligible hemodialysis patients. The fluid status of all patients was evaluated by clinical examination, lung ultrasound, inferior vena cava (IVC) indices, and echocardiography pre and post-dialysis. The mean age was 48.20 ± 13.81 years with male predominance (n = 66,71%). Only 28 patients (30%) had NYHA class III dyspnea. Edema and lung crackles were observed in 5 (5.4%) and 8 patients (8.6%), respectively. The Mean Lung USG B lines pre- and post -dialysis were 3.527 ± 4.636 and 0.484 ± 1.419, respectively. Pre-HD lung USG B-lines showed significant correlations with edema (p = 0.05) and echocardiographic parameters, such as E/E' ratio (r = 0.35, p = 0.001), E velocity (r = 0.21, p = 0.04), and pulmonary pressure (r = 0.33, p = 0.001). A moderately positive correlation was also found between the maximum diameter of the IVC pre-dialysis and lung USG B-lines (P < 0.001). Lung USG is a promising technique for estimating EVLW in patients on dialysis. Significant correlations between pre-dialysis lung USG B-lines and echocardiographic measures of cardiac function, IVC maximum diameter and edema suggest a link between cardiac performance and volume status. This could complement clinical skills in determining dry weight.
PMID:41577695 | DOI:10.1038/s41598-025-32769-2