Kidney Week

Abstract: SA-PO358

A Simplified Lung Ultrasound-Guided Management Protocol of Pulmonary Congestion in Hemodialysis

Session Information

• Hypertension, CVD, and the Kidneys: Clinical Research
  October 26, 2024 | Location: Exhibit Hall, Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Hypertension and CVD

• 1602 Hypertension and CVD: Clinical

Authors

• Kaysi, Saleh, UVC Brugmann, Brussels, Belgium

Saleh Kaysi, MD, FASN

• Hamad, Abdullah Ibrahim, Hamad Medical Corporation, Doha, Ad Dawhah, Qatar

Abdullah Ibrahim Hamad, MD, FASN

• Taghavi, Maxime, UVC Brugmann, Brussels, Belgium

Maxime Taghavi, MD

• Ibrahim, Rania Abdelaziz, Hamad Medical Corporation, Doha, Ad Dawhah, Qatar

Rania Abdelaziz Ibrahim, RN

• Ateya, Heba Mohamed, Hamad Medical Corporation, Doha, Ad Dawhah, Qatar

Heba Mohamed Ateya

• Mathew, Mincy, Hamad Medical Corporation, Doha, Ad Dawhah, Qatar

Mincy Mathew, RN

• Alkadi, Mohamad M., Hamad Medical Corporation, Doha, Ad Dawhah, Qatar

Mohamad M. Alkadi, MD

• Al-Malki, Hassan A., Hamad Medical Corporation, Doha, Ad Dawhah, Qatar

Hassan A. Al-Malki, MD

• Nortier, Joelle L., UVC Brugmann, Brussels, Belgium

Joelle L. Nortier, MD, PhD

Background

Pulmonary congestion PC is frequent in Hemodialysis HD. We validated the first simplified LUS-guided PC management protocol in HD and evaluated its impact on blood pressure BP.

Methods

Prospective randomized multi-center trial: stable HD patients in 3 countries.
Randomized: active A and control C groups.
Bedside LUS after mid-week session at: Day 1, 15, 30, 45, 60.
LUS according to the 8-zone method. B line score BLS of > 5 represented significant PC.
Dry weight DW was adapted according to standard of care in the C group. In the A group, in addition, if BLS was > 5 at day 1 or 15 then DW was reduced by 500 g.
Home BP monitoring HBPM weekly.

Results

100 HD patients up until now. Age (60.5 ± 14.6) years, 60% diabetics.

In the A group, mean BLS at day 1 (13.5 ± 9) decreased (8.32 ± 6.8) at day 60. (P<0.001). Figure 1, with a reduction in DW (P: 0.001) and greater UF (P: 0.047). Table 1
A reduction in diastolic blood pressure was noted (P: 0.001)
In the control group, BLS did not change.

Conclusion

Our simplified LUS guided management protocol was able to safely reduce the pulmonary congestion in HD patients in addition to better controlling their blood pressure.