Sonoelastographic evaluation of diaphragmatic thickness and stiffness in dialysis patients
Küçük Resim Yok
Tarih
2025
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Bmc
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Objectives This study aimed to quantitatively and noninvasively assess diaphragmatic alterations in patients with end-stage renal disease undergoing hemodialysis (HD) or peritoneal dialysis (PD) using ultrasonography (US) and shear wave elastography (SWE). Methods This prospective cross-sectional study included 69 dialysis patients (HD, n = 37; PD, n = 32) and 60 demographically matched healthy controls. Right hemidiaphragm was evaluated using greyscale US and SWE through the 8th-10th intercostal spaces in the mid-axillary line. Thickness and stiffness were measured at end-expiration and peak inspiration phases. Clinical data, laboratory parameters, and dialysis-related metrics were recorded. Comparative and correlational analyses were performed using appropriate statistical methods. Results At peak inspiration, the measurements were 2.24 +/- 0.25 mm and 25.61 +/- 6.15 kPa for the HD group, 2.53 +/- 0.23 mm and 32.79 +/- 5.31 kPa for the PD group, and 2.86 +/- 0.29 mm and 47.68 +/- 6.67 kPa for the control group. Significant differences were observed between the groups for both parameters (p < 0.001). At end expiration, diaphragm thickness and stiffness were 1.69 +/- 0.20 mm/19.46 +/- 4.37 kPa, 1.75 +/- 0.19 mm/22.62 +/- 4.84 kPa, and 2.00 +/- 0.19 mm/33.26 +/- 4.62 kPa in the HD, PD, and control groups, respectively. There were significant differences between the groups (p < 0.05). ROC analysis indicated excellent diagnostic performance of these parameters for distinguishing dialysis patients from controls (AUC 0.806-0.987). Furthermore, diaphragm parameters correlated significantly with dialysis duration, adequacy, comorbidity, and serum albumin levels. Conclusion Diaphragm thickness and stiffness are reduced in dialysis patients, especially those on hemodialysis. US and SWE may serve as early imaging biomarkers for respiratory sarcopenia.
Açıklama
Anahtar Kelimeler
Dialysis, Diaphragm, Sarcopenia, Shear wave elastography, Ultrasonography
Kaynak
Bmc Medical Imaging
WoS Q Değeri
Q1
Scopus Q Değeri
N/A
Cilt
25
Sayı
1
