ArticleMedicine2015
Effective and timely evaluation of pulmonary congestion: qualitative comparison between lung ultrasound and thoracic bioelectrical impedance in maintenance hemodialysis patients.
Article in Medicine, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 23 papers, 2 of them syntheses that pooled it.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
23 citing papers in PubMed, 2 syntheses or guidelines pooled it, 61 citations in OpenAlex.
- Recommendations for Lung Ultrasound in Internal Medicine.Diagnostics (Basel, Switzerland) · 2020Guideline
- Blood pressure and volume management in dialysis: conclusions from a Kidney Disease: Improving Global Outcomes (KDIGO) Controversies Conference.Kidney international · 2020Guideline
- Multimodal Diagnostic Ultrasound for Congestion, Perfusion, and Ultrafiltration Tolerance in Maintenance Hemodialysis: A Narrative Review.Diagnostics (Basel, Switzerland) · 2026Review
- International evidence-based recommendations for point-of-care lung ultrasound : 2025 focused update of the 2012 recommendations.Intensive care medicine · 2026Article
- Scanning more corresponds to more accuracy in hemodialysis patients: 28-zone protocol's superior findings from an observational study.Journal of ultrasound · 2025Observational
- Lung Ultrasound in Hemodialysis Patients-Which Protocol Is More Accurate and Informative in Daily Clinical Practice: A Systematic Review.Life (Basel, Switzerland) · 2025Review
- A machine learning-based lung ultrasound algorithm for the diagnosis of acute heart failure.Internal and emergency medicine · 2024Article
- Association of Lung Ultrasound B-Lines with Left Ventricular Diastolic Function in Clinically Euvolemic Haemodialysis Patients.Blood purification · 2024Article
- Lung ultrasonography performed by nephrologist: COVID-19 as an opportunity to reveal ultrasound's full potential and usefulness in the dialysis room.Clinical kidney journal · 2023Article
- Volume Status Assessment by Lung Ultrasound in End-Stage Kidney Disease: A Systematic Review.Canadian journal of kidney health and disease · 2023Review
- The role of lung ultrasonography in the assessment of overhydration in maintenance hemodialysis patients.Renal failure · 2022Observational
- Lung Ultrasound Estimates the Overhydration and Benefits Blood Pressure Control in Normal or Mild Symptomatic Hemodialysis Patients.International journal of nephrology and renovascular disease · 2022Article
- Bedside sonographic assessments for predicting predialysis fluid overload in children with end-stage kidney disease.European journal of pediatrics · 2021Article
- Lung ultrasound methods for assessing fluid volume change and monitoring dry weight in pediatric hemodialysis patients.Pediatric nephrology (Berlin, Germany) · 2021Observational
- Lung ultrasound and BNP to detect hidden pulmonary congestion in euvolemic hemodialysis patients: a single centre experience.BMC nephrology · 2021Article
- Article
- Prediction of readmissions and mortality in patients with heart failure: lessons from the IMPEDANCE-HF extended trial.ESC heart failure · 2018Article
- Lung ultrasonography in end-stage renal disease: moving from evidence to practice-a narrative review.Clinical kidney journal · 2018Article
- Relevance of B-Lines on Lung Ultrasound in Volume Overload and Pulmonary Congestion: Clinical Correlations and Outcomes in Patients on Hemodialysis.Cardiorenal medicine · 2018Article
- Finding covert fluid: methods for detecting volume overload in children on dialysis.Pediatric nephrology (Berlin, Germany) · 2016Observational
Corrections and comments
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Authors and funding
7 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
The assessment of pulmonary congestion in maintenance hemodialysis (MHD) patients is challenging. Bioelectrical impedance analysis (BIA) can estimate body water compartments. Natriuretic peptides are markers of hemodynamic stress, neurohormonal activation and extracellular volume overload. Lung ultrasound (LUS) has been proposed for the non-invasive estimation of extravascular lung water through B-lines assessment. Up to now, no study evaluated the correlation between B-lines, segmental thoracic BIA, and natriuretic peptides in MHD patients. The aims of this study were: (1) To validate LUS as a tool for an effective and timely evaluation of pulmonary congestion in MHD patients, in comparison with segmental thoracic BIA, and with natriuretic peptides; (2) To compare a comprehensive whole chest ultrasound scanning with a simplified and timely scanning scheme limited to the lateral chest regions.Thirty-one MHD adult patients were examined. LUS, total body and thoracic BIA, and natriuretic peptides were performed immediately before and after a mid-week dialysis session. The number of B-lines assessed by LUS was compared with total body and thoracic impedance data and with natriuretic peptides.Pre-HD B-lines ranged 0-147 (mean 31) and decreased significantly post-HD (mean 16, P < 0.001). A significant correlation was found between the number of B-lines and extra-cellular water index (ECWI, r = 0.45, P < 0.001), with thoracic impedance (r = 0.30, P < 0.05), and with BNP (r = 0.57, P < 0.01). The dynamic changes in B-lines correlated better with thoracic impedance than with total body impedance, and correlated with extra-cellular but not with intra-cellular water index. The correlation between B-lines and ECWI was similar when LUS was limited to the lateral chest regions or performed on the whole chest. Multivariate analysis showed that only segmental thoracic impedance was an independent predictor of residual pulmonary congestion.The dynamic changes in B-lines after hemodialysis are correlated to the changes in total body and extra-cellular water, and particularly to lung fluids removal. B-line assessment in MHD patients is highly feasible with a simplified and timely scanning scheme limited to the lateral chest regions. These premises make B-lines a promising biomarker for a bedside assessment of pulmonary congestion in MHD patients.
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