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Methods of assessment of volume status in hemodialysis patients

Publication at Faculty of Medicine in Hradec Králové |
2016

Abstract

The prognosis of haemodialysed patients is determined by the presence of cardiovascular diseases. A key factor that can contribute to the decreasing of morbidity and death rates associated with them is optimal hydration.

In everyday practice, it is assessed by physical examination, monitoring blood pressure and heart rate changes and also by taking into account patients' subjective symptoms. To assess optimal hydration more accurately, more objective methods are needed, such as central venous pressure monitoring, plain chest radiograph, ultrasound measurement of inferior vena cava diameter, bioimpedance spectroscopy, laboratory assessment of brain natriuretic peptide and assessing the changes in ultrafiltration including measurements of the relative blood volume changes during haemodialysis.

A new method that may be used in haemodialysis patients is the lung ultrasound with B-line detection. There are no clear recommendations when selecting the accurate method of fluid assessment because of the complexity of this topic and the procedures vary between individual workplaces.