1319 “Peritoneal volume influence on bedside ultrasound or point-of-care ultrasonography (POCUS) volume assessment in peritoneal dialysis patients”

• Published in: Nephrology, dialysis, transplantation Vol. 39; no. Supplement_1
• Main Authors: Rincón, María Muñiz, Barbieri, Diego, López de la Manzanara Pérez, Virginia, Ortiz, Cristina Riaza, López, Rómulo Katsu Loayza, Fernández, Carlos Fernández, Herrero, José, Sánchez-Fructuoso, Ana I
• Format: Journal Article
• Language: English
• Published: 23.05.2024
• ISSN: 0931-0509; 1460-2385
• DOI: 10.1093/ndt/gfae069.938

Abstract Background and Aims To study the variations in hydrosaline overload ultrasound parameters using PoCUS in PD patients with full and drained peritoneum and their correlation with clinical parameters. Method PoCUS and intra-abdominal pressure (IAP) measurements were performed on included patients with a full peritoneum. After drainage, a new PoCUS and a bioimpedance analysis (BIA) were conducted. Results Seventeen patients were included: 70.6% male, mean age 66 ± 9.5 years. 65% had hydrosaline overload >1L as assessed by BIA. The mean IAP was 15 ± 3.9 mmHg. The maximum diameter of the IVC with full and drained peritoneum was 1.44 ± 0.35 cm and 1.53 ± 0.4 cm, respectively, with no significant difference (p = 0.179). The % collapsibility of IVC with full and drained peritoneum was 49 ± 23% and 47 ± 13%, respectively, with no significant difference (p = 0.58). Kerley B-lines with full peritoneum were 1.3 ± 1.5, and with drained peritoneum were 0.71 ± 1.16, with this difference approaching statistical significance (p = 0.063). The same analyses in subgroups of patients with volume overload by BIA (OH>1 or OH/ECW>15%) did not show significant differences. In the correlation analysis of variables, IAP and peritoneal dialysis fluid volume per m2 of body surface did not correlate with the diameters or collapsibility of IVC with full or drained peritoneum. The degree of overhydration by OH (L) correlated with IVC collapsibility with drained peritoneum (Spearman ρ = −0.43; p = 0.08), as did the overhydration by OH/ECW (Spearman ρ = −0.61; p = 0.02). These correlations disappeared with full peritoneum (p > 0.05). The same correlation analyses were performed in subgroups of patients with volume overload by BIA (OH>1L or OH/ECW>15%) and were not significant with either full or drained peritoneum. Conclusion We did not find significant differences in the ultrasound volume overload parameters with full vs. drained peritoneum in PD patients. However, indirect data indicate a lower sensitivity of PoCUS to hydrosaline overload with a full peritoneum.