This observational study aimed to address the challenge of determining ideal weight in hemodialysis patients, where fluid status plays a critical role. Lung Ultrasound (LUS) has emerged as a valuable tool for assessing hydration status in these patients. This study explored the effectiveness of LUS combined with Inferior Vena Cava (IVC) ultrasonography in defining fluid status, conducted at the Dialysis Unit of Papageorgiou General Hospital in Thessaloniki with a cohort of 68 hemodialysis patients. Each patient underwent both lung and IVC ultrasound 30 minutes before and after their dialysis session, conducted by a nephrology trainee. Importantly, ideal weight adjustments were based on clinical assessments rather than ultrasound findings. Fluid status was evaluated through the presence of B lines in LUS and the IVC diameter as an indicator of hydration levels.
The study results showed that the average B line score was 11.53 ± 5.02 before dialysis, which significantly reduced to 5.57 ± 3.14 post-session, indicating a notable reduction in lung fluid. Similarly, the IVC diameter decreased from an average of 14.266 ± 0.846 mm before dialysis to 12.328 ± 0.879 mm after. Patients were grouped based on their overhydration levels, and the findings were evaluated for statistical significance. A key result was the significant correlation between the B line score and the IVC diameter adjusted for body surface area post-dialysis (p = 0.009 < 0.05). The study also identified that 25% of patients showed signs of hyperhydration before dialysis. These findings demonstrate that LUS combined with IVC measurement is an effective, feasible method for nephrology trainees to assess fluid status in hemodialysis patients, highlighting the potential for broader clinical application. Future intervention studies are recommended to validate and expand on these results.
