Sonoelastographic evaluation of diaphragmatic thickness and stiffness in dialysis patients

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dc.contributor.authorDag, Nurullah
dc.contributor.authorBerktas, Haci Bayram
dc.contributor.authorUslu, Aysun Gunduz
dc.contributor.authorBurulday, Veysel
dc.date.accessioned2026-04-04T13:33:10Z
dc.date.available2026-04-04T13:33:10Z
dc.date.issued2025
dc.departmentİnönü Üniversitesi
dc.description.abstractObjectives 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.
dc.identifier.doi10.1186/s12880-025-01932-6
dc.identifier.issn1471-2342
dc.identifier.issue1
dc.identifier.orcid0000-0003-3154-8477
dc.identifier.orcid0000-0002-9342-0244
dc.identifier.pmid41013361
dc.identifier.scopus2-s2.0-105017417214
dc.identifier.scopusqualityN/A
dc.identifier.urihttps://doi.org/10.1186/s12880-025-01932-6
dc.identifier.urihttps://hdl.handle.net/11616/108974
dc.identifier.volume25
dc.identifier.wosWOS:001582537400002
dc.identifier.wosqualityQ1
dc.indekslendigikaynakWeb of Science
dc.indekslendigikaynakScopus
dc.indekslendigikaynakPubMed
dc.language.isoen
dc.publisherBmc
dc.relation.ispartofBmc Medical Imaging
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanı
dc.rightsinfo:eu-repo/semantics/openAccess
dc.snmzKA_WOS_20250329
dc.subjectDialysis
dc.subjectDiaphragm
dc.subjectSarcopenia
dc.subjectShear wave elastography
dc.subjectUltrasonography
dc.titleSonoelastographic evaluation of diaphragmatic thickness and stiffness in dialysis patients
dc.typeArticle

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