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 Pocus
Studying Fluid Levels in Home Dialysis Patients
Nupur Gupta
Primary Investigator
Brief description of study
This study will compare fluid status evaluation by different modalities which include patient score (using a scale called modified medical research council dyspnea scale), physical examination by kidney doctor and Lung Ultrasound in order to learn the best way to judge how much fluid patients on home dialysis (including peritoneal dialysis and home hemodialysis) have.
Detailed description of study
To investigate the concordance and discordance of volume status assessment among three methods: patient-reported symptoms (mMRC), physical examination, and lung ultrasound in home dialysis patients. Participants will not be randomized. All participants will undergo the same assessment protocol, which includes the administration of the mMRC dyspnea scale, a physical examination, and lung ultrasound (LUS) to evaluate for B-lines.
Eligibility of study
You may be eligible for this study if you meet the following criteria:
- Conditions: End-stage kidney disease (ESKD)
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Age: 18 years - 100 years
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Gender: All
Inclusion Criteria
1. Age: Greater than 18 years.
2. Diagnosis: End-stage kidney disease (ESKD).
3. Treatment: Receiving home dialysis, either peritoneal dialysis (PD) or home hemodialysis (HHD).
4. Duration of Home Dialysis: At least three months on home dialysis.
Exclusion Criteria
1. Consent: Inability to provide informed consent.
2. Inclusion Criteria: Not meeting any of the inclusion criteria.
3. Pregnancy.
4. Urgent-Start PD.
5. Any other obvious cause of shortness of breath not related to volume overload including but not limited to pneumonia, pneumothorax, advanced COPD and Interstitial lung disease.
This study investigates how to best evaluate fluid levels in people who are on home dialysis, which includes peritoneal dialysis and home hemodialysis. The study compares three methods: a patient-reported symptom scale called the modified Medical Research Council (mMRC) dyspnea scale, physical exams by kidney doctors, and lung ultrasounds. These methods help understand how much fluid is in the body, which is important for people with end-stage kidney disease.
Participants will undergo three procedures: answering questions about their breathing using the mMRC scale, having a physical exam by a kidney doctor, and receiving a lung ultrasound. The lung ultrasound checks for B-lines, which are lines seen in the lungs that can indicate extra fluid.
- Who can participate: Adults over 18 years with end-stage kidney disease who have been on home dialysis for at least three months are eligible. Participants need to be patients at the Davita home dialysis clinic in Indianapolis and must be able to give consent. Pregnant individuals and those with certain lung conditions are not eligible.
- Study details: Participants will complete a symptom questionnaire, undergo a physical exam, and have a lung ultrasound to assess fluid levels. The study does not involve any treatment changes or new medications.
