title: Comparing lung ultrasound with bioimpedance spectroscopy for evaluating hydration in peritoneal dialysis patients.
abstract: BACKGROUND
  Bioimpedance spectroscopy (BIS), ultrasound lung comets (ULC) and serum biomarkers (N-terminal pro-brain natriuretic peptide, NT-proBNP) have all been used to assist clinicians to determine hydration status in dialysis patients.
  
  
  METHODS
  We performed simultaneous BIS, ULC and NT-proBNP measurements in 27 peritoneal dialysis patients to determine the concordance of the three methods.
  
  
  RESULTS
  Patients with evidence of increasing lung congestion (as determined by ultrasound) were more likely to be diabetic, have systolic hypertension and have higher NT-proBNP (r = 0.65, P < 0.0005). Although there was a trend for patients with high ULC to be overhydrated as determined by BIS, this did not reach statistical significance. Moreover, the correlation between BIS and NT-proBNP (though statistically significant at r = 0.47, P < 0.02) appeared to be weaker.
  
  
  CONCLUSIONS
  BIS and ULC may be complementary, providing different information, whereas BIS may be more specific to hydration. ULC and NT-proBNP may indicate left ventricular failure coexisting with overhydration.
authors.affiliation: Department of Renal Medicine and Transplantation, Barts Health NHS Trust, London, UK.
authors.forename: Klara
authors.initials: K
authors.lastname: Paudel
authors.forename: Tarun
authors.initials: T
authors.lastname: Kausik
authors.forename: Annemarie
authors.initials: A
authors.lastname: Visser
authors.forename: Cheryl
authors.initials: C
authors.lastname: Ramballi
authors.forename: Stanley L
authors.initials: SL
authors.lastname: Fan
mesh_terms: D015415:Biomarkers / Q000097:blood; D001834:Body Water; D003430:Cross-Sectional Studies; D017097:Electric Impedance; D005260:Female; D006801:Humans; D008168:Lung / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D010446:Peptide Fragments / Q000097:blood*; D010530:Peritoneal Dialysis; D013057:Spectrum Analysis / Q000379:methods; D014463:Ultrasonography
chemical_list: D015415:Biomarkers; D010446:Peptide Fragments; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain
keywords: bioimpedance; fluid status; lung congestion; overhydration; peritoneal dialysis; ultrasound