Atmis Bahriye, Turker Ikbal, Cevizli Derya, Cagli Piskin Cagla, Ekinci Faruk, Yildizdas Dincer, Bayazit Aysun K
Department of Pediatric Nephrology, Faculty of Medicine, Çukurova University, Adana, Türkiye.
Department of Pediatric Intensive Care, Faculty of Medicine, Çukurova University, Adana, Türkiye.
Pediatr Nephrol. 2025 Jul 3. doi: 10.1007/s00467-025-06825-y.
This study aimed to assess fluid status in pediatric patients on peritoneal dialysis by combining ultrasonography and bioimpedance spectroscopy (BIS). It specifically focused on examining the changes in volume status following a 2-h dwell time ultrafiltration exchange and evaluating the reliability of these techniques.
Thirteen pediatric patients on peritoneal dialysis were enrolled in this study, and their hydration status was assessed clinically. In addition, 56 lung ultrasound measurements, inferior vena cava (IVC) collapsibility index assessments, and BIS evaluations were performed both before and after a 2-h dwell exchange using 2.27%/2.5% dextrose dialysate.
The mean age of the patients was 8.6 ± 4.1 years, and eight of them (61.5%) were male. The IVC collapsibility index significantly increased (26.3 ± 10.0% vs. 44.4 ± 9.4%; p < 0.001), and the total number of B-lines significantly decreased (median 22 vs. 11.5; p < 0.001) after a 2-h dwell exchange using 2.27%/2.5% dextrose dialysate. A positive correlation was observed between the total number of B-lines and fluid overload measured using BIS both pre-dialysis (r = 0.504, p = 0.006) and post-dialysis (r = 0.528, p = 0.004). A significant reduction in the total number of B-lines was observed across all hydration groups after dialysis (p < 0.001). The area under the receiver-operating characteristic curve (AUC) for the total number of B-lines in predicting severe overhydration was 0.685 (p = 0.097) when assessed using BIS and 0.740 (p = 0.181) when assessed by weight.
Our results highlight marked changes in fluid status parameters from pre- to post-dialysis, underscoring the clinical value of combining lung ultrasonography and BIS for monitoring fluid overload in pediatric patients undergoing peritoneal dialysis.
本研究旨在通过结合超声检查和生物电阻抗光谱法（BIS）评估接受腹膜透析的儿科患者的液体状态。它特别关注在2小时驻留时间超滤交换后容量状态的变化，并评估这些技术的可靠性。
本研究纳入了13名接受腹膜透析的儿科患者，并对他们的水化状态进行了临床评估。此外，在使用2.27%/2.5%葡萄糖透析液进行2小时驻留交换前后，分别进行了56次肺部超声测量、下腔静脉（IVC）塌陷指数评估和BIS评估。
患者的平均年龄为8.6±4.1岁，其中8名（61.5%）为男性。在使用2.27%/2.5%葡萄糖透析液进行2小时驻留交换后，IVC塌陷指数显著增加（26.3±10.0%对44.4±9.4%；p<0.001），B线总数显著减少（中位数22对11.5；p<0.001）。在透析前（r=0.504，p=0.006）和透析后（r=0.528，p=0.004），均观察到B线总数与使用BIS测量的液体过载之间存在正相关。透析后，所有水化组的B线总数均显著减少（p<0.001）。当使用BIS评估时，B线总数预测严重水合过多的受试者工作特征曲线（AUC）下面积为0.685（p=0.097），当通过体重评估时为0.740（p=0.181）。
我们的结果突出了透析前后液体状态参数的显著变化，强调了结合肺部超声检查和BIS监测接受腹膜透析的儿科患者液体过载的临床价值。
