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Concordance and Discordance in the Assessment of Volume Status in Home Dialysis Patients: A Comparison of Modified Medical Research Council Dyspnea Scale, Physical Exam, and Point of Care Ultrasound (POCUS)
Sponsor: Indiana University
Summary
Fluid overload (when the body has too much fluid), is one of the reasons why people on home dialysis need to go to the hospital. Fluid overload commonly presents as trouble breathing and leg swelling. Traditionally, doctors check for this by asking patients if they have any symptoms like leg swelling or shortness of breath and by doing a physical exam which includes listening to the lungs or looking for swelling in legs. However, a newer, safe, and non-invasive method called point-of-care ultrasound (POCUS) has become very popular. However, there is not a lot of research yet on how POCUS and LUS (lung ultrasound) specifically help home dialysis patients, including those on peritoneal dialysis or home hemodialysis. Peritoneal dialysis is a way to clean the blood by putting a special fluid into the abdomen through a small tube. The fluid uses the natural lining of the belly as a filter to remove waste and extra water. Home hemodialysis is a treatment where a machine acts like an artificial kidney to clean the blood. Patients get trained to do this themselves at home by connecting to the machine with a couple of needles, which cleans their blood of waste and extra fluid. POCUS, especially a (LUS), has been shown to be useful for dialysis patients in outpatient units. This study will compare different 3 different methods of detecting fluid overload in adult patients with End-stage kidney disease who are receiving home dialysis: answering various survey questions, completing a physical exam, and a LUS. The study seeks to determine which of these methods is the best method to determine fluid overload.
Key Details
Gender
All
Age Range
18 Years - Any
Study Type
INTERVENTIONAL
Enrollment
90
Start Date
2026-01-09
Completion Date
2026-11-30
Last Updated
2026-08-27
Healthy Volunteers
No
Interventions
point-of-care ultrasound (POCUS), specifically lung ultrasound (LUS)
An eight-zone scanning protocol will be used to count the number of B-lines. Patients will be assigned a score based on the B-line count and categorized as absent, mild, moderate, or severe for fluid overload
Modified Medical Research Council (mMRC) Dyspnea scale
The Modified Medical Research Council (mMRC) Dyspnea scale will be administered to patients to assess patient symptoms, with scores ranging from 0 to +4.
Physical Exam
Clinicians will perform a physical examination using standard practices to assess for signs of fluid overload, including lower extremity edema, crackles on auscultation, weight gain, and vital signs. Patients will then be categorized as hypovolemic, euvolemic, mild, moderate, or severe volume overloaded. The physicians will be blinded to the patient reported symptoms and the LUS.
Locations (1)
Davita Home Dialysis of Indianapolis
Indianapolis, Indiana, United States