Comparing lung ultrasound with bioimpedance spectroscopy for evaluating hydration in peritoneal dialysis patients

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Abstract

Background:

Bioimpedance spectroscopy (BIS), ultrasound lung comets (ULC) and serum biomarkers (N-terminal pro–brain natriuretic peptide, NT-proBNP) have all been used to assist clinicians to determine hydration status in dialysis patients.

Methods:

We performed simultaneous BIS, ULC and NT-proBNP measurements in 27 peritoneal dialysis patients to determine the concordance of the three methods.

Results:

Patients with evidence of increasing lung congestion (as determined by ultrasound) were more likely to be diabetic, have systolic hypertension and have higher NT-proBNP (r= 0.65,P< 0.0005). Although there was a trend for patients with high ULC to be overhydrated as determined by BIS, this did not reach statistical significance. Moreover, the correlation between BIS and NT-proBNP (though statistically significant atr= 0.47,P< 0.02) appeared to be weaker.

Conclusion:

BIS and ULC may be complementary, providing different information, whereas BIS may be more specific to hydration. ULC and NT-proBNP may indicate left ventricular failure coexisting with overhydration.

SUMMARY AT A GLANCE

We assessed fluid status in 27 peritoneal dialysis patients using bioimpedance spectroscopy (BIS), lung ultrasound (ULC) and N-terminal pro–brain natriuretic peptide (NT-proBNP). BIS and ULC appear to be complementary, although BIS may be more specific for hydration status, whereas ULC and NT-proBNP appear to be more specific for left ventricular dysfunction with pulmonary fluid overload.

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