Correlation between the Number of Lung Ultrasound B-Lines and Edema Index,NT-proBNP in Patients Undergoing Peritoneal Dialysis and Its Eval-uation Efficacy in Volume Overload

WU Nan; WU Chaoran; CHEN Xi; CHEN Yuhua; WANG Xueqin; SHI Feng

doi:10.3969/j.issn.1002-3429.2024.08.011

Abstract：Objective To investigate the correlation between the number of lung ultrasound B-lines and the edema in-dex,N-terminal pro-brain natriuretic peptide(NT-proBNP)in patients undergoing peritoneal dialysis,and to evaluate its effi-cacy in assessing volume overload.Methods A total of 50 patients with uremia undergoing peritoneal dialysis with volume overload(overload group)and 50 patients with uremia undergoing peritoneal dialysis without volume overload(control group)were selected at a ratio of 1∶1 from January 2022 to August 2023 as the research subjects.Lung ultrasound was used to detect the number of B-lines in both groups.Pearson simple linear correlation analysis was used to analyze the correlation of the num-ber of B-lines with the edema index and NT-proBNP levels.The baseline data of the two groups,as well as the number of B-lines,edema index,and NT-proBNP before and after dialysis,were compared.Partial correlation analysis was used to ana-lyze the relevant factors affecting volume overload in patients undergoing peritoneal dialysis.The receiver operating characteris-tic(ROC)curve was used to analyze the predictive value of the number of B-lines,edema index,and NT-proBNP for volume overload.Results Before and after dialysis,the number of B-lines was significantly and positively correlated with edema in-dex and NT-proBNP(P＜0.01).The serum albumin and dialyzer clearance of urea multiplied by dialysis time and normal-ized for urea distribution volume(Kt/V)in the overload group were lower than those in the control group(P＜0.01).The number of B-lines,edema index,and NT-proBNP in the overload group before and after dialysis were higher than those in the control group,and these indicators were lower after dialysis in both groups(P＜0.05).After adjusting for serum albumin and Kt/V,the number of B-lines,edema index,and NT-proBNP were still positively correlated with volume overload in patients undergoing peritoneal dialysis(P＜0.01).The area under the ROC curve of the number of B-lines,edema index,and NT-proBNP for predicting volume overload in patients undergoing peritoneal dialysis were 0.784,0.709,and 0.810,respectively,while the AUC of the combination of the three was 0.936,with a predictive sensitivity of 88.00%and specificity of 90.00%(P＜0.01).Conclusion The number of lung ultrasound B-lines is closely related to the edema index and NT-proBNP in patients undergoing peritoneal dialysis,and is associated with volume overload in patients.The combined de-tection of the three can improve the predictive ability of volume overload in patients undergoing peritoneal dialysis and provide objective reference information and decision support for volume management.