Correlation between lung ultrasound B lines and clinical as well as echocardiographic parameters in patients on maintenance hemodialysis

Patients with chronic kidney disease undergoing hemodialysis are at an increased risk of cardiovascular complications due to volume overload. Lung ultrasound (LUS) has emerged as a non-invasive tool to assess extravascular lung water (EVLW) and manage fluid excess. This study aimed to validate LUS in a relatively asymptomatic day-care dialysis population and to correlate it with clinical parameters, ECHO/IVC metrics. This prospective pre-post intervention study was conducted in a dialysis unit, enrolling 93 eligible hemodialysis patients. The fluid status of all patients was evaluated by clinical examination, lung ultrasound, inferior vena cava (IVC) indices, and echocardiography pre and post-dialysis. The mean age was 48.20 ± 13.81 years with male predominance (n = 66,71%). Only 28 patients (30%) had NYHA class III dyspnea. Edema and lung crackles were observed in 5 (5.4%) and 8 patients (8.6%), respectively. The Mean Lung USG B lines pre- and post -dialysis were 3.527 ± 4.636 and 0.484 ± 1.419, respectively. Pre-HD lung USG B-lines showed significant correlations with edema (p = 0.05) and echocardiographic parameters, such as E/E' ratio (r = 0.35, p = 0.001), E velocity (r = 0.21, p = 0.04), and pulmonary pressure (r = 0.33, p = 0.001). A moderately positive correlation was also found between the maximum diameter of the IVC pre-dialysis and lung USG B-lines (P < 0.001). Lung USG is a promising technique for estimating EVLW in patients on dialysis. Significant correlations between pre-dialysis lung USG B-lines and echocardiographic measures of cardiac function, IVC maximum diameter and edema suggest a link between cardiac performance and volume status. This could complement clinical skills in determining dry weight.