Lung Ultrasound: A Reliable Tool for a Better Estimation of Dry Weight in Chronic Haemodialysis Patients

Introduction: Volume overload, whether overt or subclinical, is associated with increased cardiovascular mortality in chronic haemodialysis patients. The assessment of dry weight remains a challenge and relies on clinical and paraclinical methods. Pulmonary ultrasound could thus prove useful as an additional tool in improving the management of haemodialysis patients, possibly in addition to bioimpedance metry data. Method: To assess the interest and feasibility of lung ultrasound in the evaluation of dry weight overload in comparison with clinical examination in hemodialysis patients. We conducted a study in our dialysis unit at the MOHAMMED V military training hospital. The patients were all dialysed on a NIKKISSO machine. Each patient had a pulmonary ultrasound 30 minutes after the HD session, with measurement by B-line counting on 8 zones. Cardiac ultrasound and chest X-ray were performed to assess volume overload. Clinical parameters scheduled and performed UF were also recorded. Results: Between March and May 2022, 37 patients were included with a mean age of 57.4 ± 16.7 years [26; 83] and a female predominance of 54.1%. Subclinical overload was detected on lung ultrasound in 45.9% versus 18.9% on clinical examination. A significant correlation between the Kerley B line and pre-dialytic hypertension and overload was found, with a correlation coefficient of 0.038 (p < 0.05). No significant correlation was found between B-lines and clinical examination (oedema, NYHA stage, crepitus). Conclusion: Pulmonary ultrasound appears to be easy to use in routine and effective for dry weight assessment, in addition to other assessment methods.