Ultrasound useful for early detection of lung congestion in dialysis patients

Italian researchers have found that ultrasound can be used in the early detection of fluid in dialysis patients' lungs, which could prevent the development of fatal heart problems.

The researchers, led by Carmine Zoccali, M.D., director of the nephrology, hypertension and renal transplantation unit at Riuniti Hospital in Reggio Calabria, reported the results of their study online in the Journal of the American Society of Nephrology.

Patients who undergo dialysis for kidney failure also can suffer heart failure as well, and are at risk of developing congestion in their lungs, potentially leading cardiac events, or even death.

In the study Zoccali and his colleagues measured the amount of fluid in the lungs of 392 dialysis patients using ultrasound. They found moderate-to-severe lung congestion in 45 percent of patients, and very severe congestion in 14 percent. However, 71 percent of those patients with moderate-to-severe lung congestion had either no symptoms or slight symptoms of heart failure.

Over a two-year follow-up period, patients with very severe congestion had a 4.2-fold increased risk of dying, and a 3.2-fold increased risk of experiencing heart attacks or other cardiac events compared with those having slight or no lung congestion.

The authors concluded that lung congestion detected in asymptomatic patients via ultrasound is a better indicator of a patient's risk of premature death or suffering a cardiac event than symptoms of heart failure.

"Our findings generate the hypothesis that targeting subclinical pulmonary congestion may improve cardiovascular health and reduce risk from cardiovascular death in the dialysis population, a population at an extremely high risk," Zoccali said in an announcement, adding longer and/or more frequent dialysis could reduce lung congestion.

To learn more:
- read the study abstract
- see the announcement