Department of Nephrology, Hippokration Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece.
Kidney Blood Press Res. 2022;47(3):163-176. doi: 10.1159/000521691. Epub 2022 Jan 10.
Volume overload is the main mechanism of BP elevation in end-stage kidney disease (ESKD) patients undergoing hemodialysis or peritoneal dialysis and has been linked to adverse outcomes and increased mortality in this population.
This review discusses current knowledge on lung ultrasound as a tool for detection of extracellular volume overload through evaluation of extravascular lung water content. We describe the principles of lung US, the main protocols to apply it in clinical practice, and accumulated data evidence regarding its associations with cardiovascular events and mortality. We also summarize available evidence on the effect of lung ultrasound-guided -volume management strategies on BP control, echocardiographic parameters, and major outcomes in patients undergoing dialysis.
Among interventions attempting to reduce the burden of cardiovascular disease in ESKD, effective management of volume overload represents an unmet clinical need. Assessment of hydration status by lung ultrasound is a cheap, easy to employ, and real-time technique that can offer accurate dry weight assessment leading to several clinical benefits.
容量超负荷是终末期肾病（ESKD）患者在接受血液透析或腹膜透析时血压升高的主要机制，与该人群的不良结局和死亡率增加有关。
本综述讨论了当前关于肺部超声作为一种通过评估血管外肺水含量来检测细胞外容量超负荷的工具的知识。我们描述了肺部超声的原理、在临床实践中应用的主要方案，以及关于其与心血管事件和死亡率之间关联的累积数据证据。我们还总结了关于肺部超声指导下的容量管理策略对透析患者血压控制、超声心动图参数和主要结局影响的现有证据。
在试图减轻 ESKD 患者心血管疾病负担的干预措施中，有效管理容量超负荷是一个未满足的临床需求。肺部超声评估水合状态是一种廉价、易于实施和实时的技术，可提供准确的干体重评估，从而带来多项临床获益。
