Assessment of fluid removal using ultrasound, bioimpedance and anthropometry in pediatric dialysis: a pilot study

BMC Nephrology

Research

Oluwatimilehin Okunowo¹  Laura Poznick²  Susan J. Back³  Hansel J. Otero³  Babette S. Zemel⁴  Abdulla M. Ehlayel⁵  Mohini Dutt⁶  Kathryn Howarth⁶  Xenia Morgan⁶  Lawrence Copelovitch⁷  Michelle R. Denburg⁷  Erum A. Hartung⁷ 

[1] Data Science & Biostatistics Unit, Department of Biomedical and Health Informatics, Children’s Hospital of Philadelphia, Philadelphia, USA;Department of Radiology, Children’s Hospital of Philadelphia, Philadelphia, USA;Department of Radiology, Children’s Hospital of Philadelphia, Philadelphia, USA;Perelman School of Medicine, University of Pennsylvania, Philadelphia, USA;Division of Gastroenterology, Hepatology and Nutrition, Children’s Hospital of Philadelphia, Philadelphia, USA;Perelman School of Medicine, University of Pennsylvania, Philadelphia, USA;Division of Nephrology, Children’s Hospital of New Orleans, 200 Henry Clay Ave, 70118, New Orleans, LA, USA;Division of Nephrology, Children’s Hospital of Philadelphia, Philadelphia, USA;Division of Nephrology, Children’s Hospital of Philadelphia, Philadelphia, USA;Perelman School of Medicine, University of Pennsylvania, Philadelphia, USA;

关键词: Fluid overload;    Pediatric hemodialysis;    Ultrasound;    Anthropometry;    Multi-frequency bioimpedance;    Isotope dilution;   

DOI  :  10.1186/s12882-022-03012-1

 received in 2022-01-24, accepted in 2022-11-18,  发布年份 2022

来源: Springer

【 摘 要 】

BackgroundFluid overload is associated with morbidity and mortality in children receiving dialysis. Accurate clinical assessment is difficult, and using deuterium oxide (D2O) to measure total body water (TBW) is impractical. We investigated the use of ultrasound (US), bioimpedance spectroscopy (BIS), and anthropometry to assess fluid removal in children receiving maintenance hemodialysis (HD).MethodsParticipants completed US, BIS, and anthropometry immediately before and 1–2 h after HD for up to five sessions. US measured inferior vena cava (IVC) diameter, lung B-lines, muscle elastography, and dermal thickness. BIS measured the volume of extracellular (ECF) and intracellular (ICF) fluid. Anthropometry included mid-upper arm, calf and ankle circumferences, and triceps skinfold thickness. D2O was performed once pre-HD. We assessed the change in study measures pre- versus post-HD, and the correlation of change in study measures with percent change in body weight (%∆BW). We also assessed the agreement between TBW measured by BIS and D2O.ResultsEight participants aged 3.4–18.5 years were enrolled. Comparison of pre- and post-HD measures showed significant decrease in IVC diameters, lung B-lines, dermal thickness, BIS %ECF, mid-upper arm circumference, ankle, and calf circumference. Repeated measures correlation showed significant relationships between %∆BW and changes in BIS ECF (rrm =0.51, 95% CI 0.04, 0.80) and calf circumference (rrm=0.80, 95% CI 0.51, 0.92). BIS TBW correlated with D2O TBW but overestimated TBW by 2.2 L (95% LOA, -4.75 to 0.42).ConclusionBIS and calf circumference may be helpful to assess changes in fluid status in children receiving maintenance HD. IVC diameter, lung B-lines and dermal thickness are potential candidates for future studies.

【 授权许可】

CC BY   
© The Author(s) 2023

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