Study of Lung Ultrasound and Caval Indices to Assess Volume Status in Maintenance Hemodialysis Patients

Kamel, Reda Abd Elmoniem; Ghorab, Adel A.M.; Assy, Mostafa Mohamad; Makhlouf, Rodalia M.; Alahmadi, Doaa Mohammed Mohammed; Gooda, Tamer Mohammed

doi:10.21608/zumj.2025.358230.3830

	Study of Lung Ultrasound and Caval Indices to Assess Volume Status in Maintenance Hemodialysis Patients
Zagazig University Medical Journal
Article 17, Volume 31, Issue 4, April 2025, Pages 1552-1564 PDF (866.49 K)
Document Type: Original Article
DOI: 10.21608/zumj.2025.358230.3830
Authors
Reda Abd Elmoniem Kamel¹; Adel A.M. Ghorab¹; Mostafa Mohamad Assy²; Rodalia M. Makhlouf¹; Doaa Mohammed Mohammed Alahmadi^* ¹; Tamer Mohammed Gooda¹
¹Internal medicine and nephrology Department, Faculty of Medicine, Zagazig University
²Radiology Department, Faculty of Medicine, Zagazig University
Abstract
Background: Point of care ultrasound (POCUS) is a useful technique for determining volume status. Lung POCUS is a radiation-free, non-invasive technique that can help determine dry weight, estimate extravascular lung water (EVLW), and identify pulmonary congestion before it becomes clinically noticeable. This study aimed to evaluate the utility of POCUS parameters in assessing volume status among end-stage kidney disease (ESKD) patients on maintenance hemodialysis (HD). Methods: This cross section study was conducted at the outpatient hemodialysis unit at Zagazig University Hospital and Alshorouk General Hospital on 60 ESKD patients on maintenance HD. Lung ultrasound was measured in all cases. Results: The most striking findings of our study regarding ultrasound parameters of volume status were related to the assessment of B-lines. During the first visit, 80% of patients presented with more than three B-lines pre-dialysis, which decreased to 50% post-dialysis. In the second assessment, 50% of patients had more than three B-lines pre-dialysis, but this number significantly dropped to 26.7% after dialysis. Conclusion: Point-of-care ultrasound is a valuable tool for objective assessment of volume status in hemodialysis patients, capable of detecting subclinical volume overload even in the absence of physical signs. The significant improvements observed in ultrasound parameters (B-lines, IVC diameter, and IVC collapsibility) between first and second assessments validate its utility in guiding volume management.
Keywords
Lung ultrasound; caval indices; volume status; hemodialysis; B-lines

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