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Dry weight is indeed an essential part of the management of hemodialysis patients. In the assessment of dry weight, clinical dry weight determent is often difficult. Lung ultrasound can be assessed for fluid status by detecting extravascular lung water congestion as B line score. This study aimed to study the relationship of volume status between clinical criteria and lung ultrasound in hemodialysis patients.
A hospital-based before and after comparative study done in No. (1) Defence Services General Hospital, Hemodialysis unit. Yangon from October 2020 to June 2023. Total 52 participants were included. Before and after hemodialysis, all participants underwent assessments using both clinical examination and lung ultrasound.
Before HD, among the patients, a group of 29 individuals was classified as hypervolemic based on clinical criteria (n=29): 27.6% exhibited a severe degree of volume overload by lung ultrasound (USG). 69.0% showed a moderate degree of volume overload. Only 3.4% had a mild degree of volume overload All of the hypervolemic patients had a positive degree of volume overload in the lung USG score. For patients classified as euvolemic based on clinical criteria (n=23): There were no cases of severe or moderate volume overload. 56.5% showed a mild degree of volume overload. 43.5% had an absent degree of volume overload. The Spearman's rank correlation coefficient (ρ) value of 0.883, p < 0.001.
After hemodialysis (HD), among the patients, a group of 20 individuals was classified as hypervolemic based on clinical criteria (n=20): five percent displayed a severe level of volume overload. 70.0% exhibited a moderate level of volume overload. 25.0% showed a mild level of volume overload. None of the hypervolemic patients had an absent level of volume overload after HD. After HD, for patients classified as euvolemic based on clinical criteria (n=32): There were no cases of severe volume overload.18.8% showed a moderate degree of volume overload. 31.2% had a mild degree of volume overload. 50.0% had an absent degree of volume overload. The Spearman's rank correlation coefficient (ρ) value of 0.622, p < 0.001.
There was a strong relationship between clinical volume status and the degree of volume overload assessed by lung ultrasound in hemodialysis patients. Before hemodialysis, the correlation was particularly robust, suggesting that clinical evaluation and lung ultrasound can effectively complement each other in assessing volume status and volume overload severity.