Abstract: 【Abstract】Objective The aim of present study was to evaluate the value of lung ultrasonography for the prediction of body fluid volume and heart function. Methods The patients treated in Shanghai Changzheng Hospital during July 2014 to July 2015 were enrolled in this study according to the inclusion criteria. Three different kinds of methods, including lung ultrasonography, bioimpedance spectroscopy and echocardiography, were used to evaluate the prediction value. The examinations were performed 30 minutes before dialysis and after dialysis for 30 minutes. Results Patients were classified into 3 groups according to comet- tail: mild, moderate and severe lung congestion. Compared with the patients in mild and moderate groups, patients in the severe group had worse heart function (c2=25.358, P＜0.001) and edema complication (c2=12.217, P=0.002). A significant reduction of the comet-tail was detected following hemodialysis (Z=-6.176, P＜0.001), and the variation was significantly correlated with ultrafiltration volume (r=0.200, P=0.039). According to the stepwise multiple regression analyses, the ejection fraction (β=-87.138, P=0.014) was an independent element for comet-tail. According to the ROC analysis, lung ultrasonography was highly accurate for the detection of overhydration [AUC: 0.841 (0.758, 0.925)]. Furthermore, the best cut-point of lung comet was 12.5 according to the bioelectrical spectroscopy. Conclusion This study proposes that lung ultrasonography is a potentially reliable method for the estimation of fluid overload and heart failure.

Key words: Maintenance hemodialysis, overhydration, comet-tail, bioelectrical impedance