The KBRH project involved using bedside ultrasound to help guide fluid removal during hemodialysis. (Photo by Robina Weermeijer on Unsplash)

Innovative Kootenay Boundary study augments care for renal patients

Project called the Lung Ultrasonographic Assessment of Volume Status in Hemodialysis Patients

Dr. Chi Zhang, Chief of Nephrology at Kootenay Boundary Regional Hospital (KBRH), is getting word out about the good results yielded by an innovative project that recently wrapped up in the hospital’s renal ward.

For starters, the news is good because the outcome of the hands-on study actually improves the quality of care for renal patients.

“This involves using bedside ultrasound to help guide fluid removal during hemodialysis,” Dr. Zhang told the Times, describing the study as “assessing volume status of dialysis patients using bedside lung ultrasound.”

The aim of the project was to use ultrasound to safely guide fluid removal therapy during hemodialysis and prevent hypotension (low blood pressure) during dialysis.

“The analysis of the results demonstrated a statistical decrease in the overall time patients were hypotensive while on dialysis,” Dr. Zhang explained.

“Furthermore, the ultrasound allowed project investigators to identify those patients with sub-clinical congestive heart failure (that is those without signs or symptoms of heart failure) who benefited from additional fluid removal.”

Lung ultrasonography has already been utilized by Intensive Care Unit and Emergency Room physicians.

“We look forward to expanding this project throughout Interior Health and engaging students and nurses to use this simple invaluable bedside tool to enhance patient safety,” Dr. Zhang shared.

“In the current environment of the pandemic I believe this (is) a welcome story.”

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Lung Ultrasonographic Assessment of Volume Status in Hemodialysis Patients, a Physician Quality Improvement project at KBRH, was conducted by: Justin Dragoman, medical student; Chi Zhang MD, Chief of Nephrology and the Department of Medicine; Marlene Johnson RN, dialysis nurse; and DharmaPaul L. Raju MD.

The KBRH Renal Program — or the Kootenay Boundary Chronic Kidney Disease Clinic — provides services promoting wellness and positive outcomes for patients and families affected by chronic kidney disease by following timely identification of kidney disease and earlier intervention.

This program offers lifestyle and disease modification strategies to delay the progression of kidney disease, prevent complications, maximize physical and mental health, and when required, prepare patients for kidney dialysis.

Hemodialysis, or simply dialysis, is a process of purifying the blood of a person whose kidneys are not working normally. This type of dialysis achieves the extracorporeal (outside the body) removal of waste products such as creatinine and urea and free water from the blood when the kidneys are in a state of kidney failure.

Hemodialysis is one of three renal replacement therapies, the other two being kidney transplant and peritoneal dialysis.



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