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Lung Ultrasound in the Management of Fluid Volume in Dialysis Patients: Potential Usefulness
Author(s) -
Zoccali Carmine
Publication year - 2016
Publication title -
seminars in dialysis
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.899
H-Index - 78
eISSN - 1525-139X
pISSN - 0894-0959
DOI - 10.1111/sdi.12559
Subject(s) - medicine , intensive care medicine , lung , asymptomatic , pulmonary edema , intravascular volume status , hemodialysis , dialysis , volume overload , cardiology , radiology , heart failure , hemodynamics
Volume overload is a hidden, pervasive complication in dialysis patients with dyspnea and pulmonary edema being its main clinical manifestations. Measuring lung water has clinical potential because it allows timely treatment of lung congestion at a preclinical stage. Chest ultrasound ( US ) is a novel, well‐validated technique that allows reliable estimates of lung water in clinical practice. The application of this technique in dialysis patients has shown that an unsuspectedly high proportion of these patients have moderate to severe lung congestion which is usually asymptomatic. Furthermore, lung congestion in these patients is only loosely associated with fluid excess as measured by bioimpedance ( BIA ). Lung congestion is associated with a high death risk in dialysis patients and therefore represents a potential treatment target. The “Lung water by Ultra‐Sound guided Treatment to prevent death and cardiovascular complications in high risk ESRD patients with cardiomyopathy” ( LUST ) study will provide important information about the clinical value of this technique in the care of hemodialysis patients at high cardiovascular risk.