A new technique for the detection of dry weight in hemodialysis patients: Estimated pulmonary capillary wedge pressure. A tissue Doppler imaging study

Fluid overload is an important factor of morbidity and mortality in hemodialysis patients. Today correct determination of dry weight (DW) remains an important issue of hemodialysis practice. Within this context, it is subjected to new method searching. The objective of this study was to calculate estimated pulmonary capillary wedge pressure (ePCWP) with Tissue Doppler Imaging (TDI) in hemodialysis patients and to evaluate its correlation with the other volume markers and to evaluate whether it can be a new method for detection of DW. Echocardiographic, hemodynamic, and biochemical volume markers of 41 hemodialysis patients were evaluated in the pre- and post-dialysis periods. Patients were divided into two groups based on ePCWP values (Group 1 ePCWP20mmHg). In the pre-dialysis period; parameters related to volume load including ePCWP, systolic blood pressure, mean arterial pressure, pulse pressure, left atrial diameter, left atrial volume, E/é, ratio and E/Vp ratio were statistically significantly higher in Group2 compared to Group1. On the other hand, strong correlations were found between pre-dialysis ePCWP and systolic blood pressure, mean arterial pressure, pulse pressure, NT-ProBNP, left atrial diameter, E/é ratio and E/Vp ratio. Strong correlations found between ePCWP which was calculated with TDI and the other volume markers both in pre-dialysis and post-dialysis periods. These findings can provide a significant contribution to routine evaluating of DW in hemodialysis patients. From this aspect, the prediction of ePCWP with TDI can be a new practical and reproducible method for the determination of DW. La hipervolemia es un factor importante de morbimortalidad en pacientes en hemodiálisis. Actualmente, la determinación correcta del peso seco (PS) sigue siendo un aspecto importante en la práctica de la hemodiálisis. Por este motivo se siguen buscando nuevos métodos. El objetivo de este estudio fue calcular la presión capilar pulmonar (PCPe) mediante ecografía Doppler tisular (EDT) en pacientes en hemodiálisis, con el fin de evaluar su correlación con los demás marcadores de volumen y valorar si podría ser un nuevo método para la determinación del PS. Se evaluaron los marcadores de volumen ecocardiográficos, hemodinámicos y bioquímicos de 41 pacientes en hemodiálisis en los periodos previos y posteriores a la diálisis. Los pacientes se dividieron en 2 grupos en función de los valores de PCPe (PCPe del grupo 1