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Year : 2019  |  Volume : 3  |  Issue : 3  |  Page : 693-700

Role of thoracic ultrasound in children with chronic kidney disease

1 Department of Pediatric, Faculty of Medicine for Girls (Cairo), Al-Azhar University, Cairo, Egypt
2 Department of Chest Diseases, Faculty of Medicine for Girls (Cairo), Al-Azhar University, Cairo, Egypt

Correspondence Address:
MD Eman Sobh
Chest Diseases Department, Faculty of Medicine for Girls, Al-Azhar University, Al-Zahraa University Hospital 11517, Cairo
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/sjamf.sjamf_85_19

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Background Chronic kidney disease (CKD) and dialysis may affect different body systems such as the cardiovascular, respiratory, and musculoskeletal system dysfunction. Pulmonary complications reported in patients with CKD include pulmonary edema, pleural effusion, pulmonary hypertension, respiratory infections, pulmonary fibrosis, and hypoxemia. Ultrasound (US) is a simple noninvasive method that is available at the bedside. It can be used to guide diagnostic and therapeutic decisions and monitor efficacy of treatment; in addition, sonographic signs are simple to learn. Aim The aim of the work was to evaluate thoracic ultrasound (TUS) findings in children of CKD and those on regular hemodialysis. Patients and methods This was a cross-sectional comparative study that was carried out on 90 children; their age ranged from 4 to 17 years. We included two groups: the first group comprised 60 patients with CKD: 30 of them on regular hemodialysis and the other 30 children with CKD not on hemodialysis. The second group was the control group (30 children). Medical history, clinical examination, anthropometric measurement, and routine laboratory studies were done. Chest radiograph and TUS were done for all patients. Computed tomography (CT) chest was done when indicated, whereas TUS in dialysis cases was done before and after dialysis. All groups were age and sex matched. Results Among the dialysis group patients, there was no significant difference between CT, US, and radiograph regarding lung congestion, consolidation, pericardial effusion, and pleural effusion. On the contrary, air trapping, cavity, granuloma, and calcified nodules were detected only with CT. US was sensitive to detect fluid overload even when body weight was below the estimated dry weight by 300 g, and B-lines more than 14 is a cutoff point with high sensitivity. In patients with CKD not on dialysis, there was no significant difference between radiograph, CT, and US chest findings regarding lung congestion, consolidation, pleural effusion, and atelectasis. Conclusion Chest US is a useful tool for the detection of pulmonary complications in pediatrics on regular hemodialysis. The technique is sensitive for detecting fluid overload and can be used for follow-up.

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