{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,3]],"date-time":"2026-05-03T10:07:43Z","timestamp":1777802863008,"version":"3.51.4"},"reference-count":21,"publisher":"Springer Science and Business Media LLC","issue":"11","license":[{"start":{"date-parts":[[2025,7,3]],"date-time":"2025-07-03T00:00:00Z","timestamp":1751500800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,7,3]],"date-time":"2025-07-03T00:00:00Z","timestamp":1751500800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"Cukurova University"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Pediatr Nephrol"],"published-print":{"date-parts":[[2025,11]]},"abstract":"<jats:title>Abstract<\/jats:title>\n          <jats:sec>\n            <jats:title>Background<\/jats:title>\n            <jats:p>This study aimed to assess fluid status in pediatric patients on peritoneal dialysis by combining ultrasonography and bioimpedance spectroscopy (BIS). It specifically focused on examining the changes in volume status following a 2-h dwell time ultrafiltration exchange and evaluating the reliability of these techniques.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods<\/jats:title>\n            <jats:p>Thirteen pediatric patients on peritoneal dialysis were enrolled in this study, and their hydration status was assessed clinically. In addition, 56 lung ultrasound measurements, inferior vena cava (IVC) collapsibility index assessments, and BIS evaluations were performed both before and after a 2-h dwell exchange using 2.27%\/2.5% dextrose dialysate.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results<\/jats:title>\n            <jats:p>The mean age of the patients was 8.6\u2009\u00b1\u20094.1\u00a0years, and eight of them (61.5%) were male. The IVC collapsibility index significantly increased (26.3\u2009\u00b1\u200910.0% vs. 44.4\u2009\u00b1\u20099.4%; <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001), and the total number of B-lines significantly decreased (median 22 vs. 11.5; <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001) after a 2-h dwell exchange using 2.27%\/2.5% dextrose dialysate. A positive correlation was observed between the total number of B-lines and fluid overload measured using BIS both pre-dialysis (<jats:italic>r<\/jats:italic>\u2009=\u20090.504, <jats:italic>p<\/jats:italic>\u2009=\u20090.006) and post-dialysis (<jats:italic>r<\/jats:italic>\u2009=\u20090.528, <jats:italic>p<\/jats:italic>\u2009=\u20090.004). A significant reduction in the total number of B-lines was observed across all hydration groups after dialysis (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001). The area under the receiver-operating characteristic curve (AUC) for the total number of B-lines in predicting severe overhydration was 0.685 (<jats:italic>p<\/jats:italic>\u2009=\u20090.097) when assessed using BIS and 0.740 (<jats:italic>p<\/jats:italic>\u2009=\u20090.181) when assessed by weight.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusion<\/jats:title>\n            <jats:p>Our results highlight marked changes in fluid status parameters from pre- to post-dialysis, underscoring the clinical value of combining lung ultrasonography and BIS for monitoring fluid overload in pediatric patients undergoing peritoneal dialysis.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Graphical abstract<\/jats:title>\n          <\/jats:sec>","DOI":"10.1007\/s00467-025-06825-y","type":"journal-article","created":{"date-parts":[[2025,7,3]],"date-time":"2025-07-03T10:45:15Z","timestamp":1751539515000},"page":"3505-3511","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Unmasking fluid overload in children on peritoneal dialysis: a multimodal diagnostic approach"],"prefix":"10.1007","volume":"40","author":[{"given":"Bahriye","family":"Atmis","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ikbal","family":"Turker","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Derya","family":"Cevizli","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cagla","family":"Cagli Piskin","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Faruk","family":"Ekinci","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dincer","family":"Yildizdas","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aysun K.","family":"Bayazit","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2025,7,3]]},"reference":[{"key":"6825_CR1","doi-asserted-by":"publisher","first-page":"324","DOI":"10.1007\/s004670100562","volume":"16","author":"T H\u00f6ltt\u00e4","year":"2001","unstructured":"H\u00f6ltt\u00e4 T, Happonen JM, R\u00f6nnholm K, Fyhrquist F, Holmberg C (2001) Hypertension, cardiac state, and the role of volume overload during peritoneal dialysis. Pediatr Nephrol 16:324\u2013331. https:\/\/doi.org\/10.1007\/s004670100562","journal-title":"Pediatr Nephrol"},{"key":"6825_CR2","doi-asserted-by":"publisher","first-page":"2491","DOI":"10.1681\/ASN.2016121341","volume":"28","author":"C Zoccali","year":"2017","unstructured":"Zoccali C, Moissl U, Chazot C, Mallamaci F, Tripepi G, Arkossy O, Wabel P, Stuard S (2017) Chronic fluid overload and mortality in ESRD. J Am Soc Nephrol 28:2491\u20132497. https:\/\/doi.org\/10.1681\/ASN.2016121341","journal-title":"J Am Soc Nephrol"},{"key":"6825_CR3","doi-asserted-by":"publisher","first-page":"233","DOI":"10.1007\/s00467-018-3916-4","volume":"34","author":"W Hayes","year":"2019","unstructured":"Hayes W, Paglialonga F (2019) Assessment and management of fluid overload in children on dialysis. Pediatr Nephrol 34:233\u2013242. https:\/\/doi.org\/10.1007\/s00467-018-3916-4","journal-title":"Pediatr Nephrol"},{"key":"6825_CR4","doi-asserted-by":"publisher","first-page":"428","DOI":"10.1053\/j.ajkd.2016.10.023","volume":"69","author":"GP Milani","year":"2017","unstructured":"Milani GP, Groothoff JW, Vianello FA, Fossali EF, Paglialonga F, Edefonti A, Agostoni C, Consonni D, van Harskamp D, van Goudoever JB, Schierbeek H, Oosterveld MJ (2017) Bioimpedance and fluid status in children and adolescents treated with dialysis. Am J Kidney Dis 69:428\u2013435. https:\/\/doi.org\/10.1053\/j.ajkd.2016.10.023","journal-title":"Am J Kidney Dis"},{"key":"6825_CR5","doi-asserted-by":"publisher","first-page":"838","DOI":"10.1007\/s12098-023-04625-6","volume":"90","author":"AE Gohary","year":"2023","unstructured":"Gohary AE, Shokry DM, Saleh SH, Baiomy SS, Gehad MH (2023) Fluid status by inferior vena cava collapsibility index, chest ultrasound and bioimpedance spectroscopy in children and adolescents on chronic hemodialysis. Indian J Pediatr 90:838. https:\/\/doi.org\/10.1007\/s12098-023-04625-6","journal-title":"Indian J Pediatr"},{"key":"6825_CR6","doi-asserted-by":"publisher","first-page":"2165","DOI":"10.1007\/s00467-022-05723-x","volume":"38","author":"L Arthur","year":"2023","unstructured":"Arthur L, Prodhan P, Blaszak R, Crawford B, Brown CC, Arthur J (2023) Evaluation of lung ultrasound to detect volume overload in children undergoing dialysis. Pediatr Nephrol 38:2165\u20132170. https:\/\/doi.org\/10.1007\/s00467-022-05723-x","journal-title":"Pediatr Nephrol"},{"key":"6825_CR7","doi-asserted-by":"publisher","first-page":"217","DOI":"10.1177\/0896860820945813","volume":"41","author":"V Karava","year":"2021","unstructured":"Karava V, Stabouli S, Dotis J, Liakopoulos V, Papachristou F, Printza N (2021) Tracking hydration status changes by bioimpedance spectroscopy in children on peritoneal dialysis. Perit Dial Int 41:217\u2013225. https:\/\/doi.org\/10.1177\/0896860820945813","journal-title":"Perit Dial Int"},{"key":"6825_CR8","doi-asserted-by":"publisher","first-page":"79","DOI":"10.3390\/jcm10010079","volume":"10","author":"PG Park","year":"2020","unstructured":"Park PG, Min J, Lim SH, Kim JH, Ahn YH, Ha IS, Kang HG (2020) Clinical Relevance of fluid volume status assessment by bioimpedance spectroscopy in children receiving maintenance hemodialysis or peritoneal dialysis. J Clin Med 10:79. https:\/\/doi.org\/10.3390\/jcm10010079","journal-title":"J Clin Med"},{"key":"6825_CR9","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1111\/nep.12342","volume":"20","author":"K Paudel","year":"2015","unstructured":"Paudel K, Kausik T, Visser A, Ramballi C, Fan SL (2015) Comparing lung ultrasound with bioimpedance spectroscopy for evaluating hydration in peritoneal dialysis patients. Nephrology (Carlton) 20:1\u20135. https:\/\/doi.org\/10.1111\/nep.12342","journal-title":"Nephrology (Carlton)"},{"key":"6825_CR10","doi-asserted-by":"publisher","first-page":"3191","DOI":"10.1007\/s00431-021-04086-z","volume":"180","author":"A Yontem","year":"2021","unstructured":"Yontem A, Cagli C, Yildizdas D, Horoz OO, Ekinci F, Atmis B, Bayazit AK (2021) Bedside sonographic assessments for predicting predialysis fluid overload in children with end-stage kidney disease. Eur J Pediatr 180:3191\u20133200. https:\/\/doi.org\/10.1007\/s00431-021-04086-z","journal-title":"Eur J Pediatr"},{"key":"6825_CR11","doi-asserted-by":"publisher","first-page":"1574","DOI":"10.1093\/ndt\/gfn707","volume":"24","author":"V Wizemann","year":"2009","unstructured":"Wizemann V, Wabel P, Chamney P, Zaluska W, Moissl U, Rode C, Malecka-Masalska T, Marcelli D (2009) The mortality risk of overhydration in haemodialysis patients. Nephrol Dial Transplant 24:1574\u20131579. https:\/\/doi.org\/10.1093\/ndt\/gfn707","journal-title":"Nephrol Dial Transplant"},{"key":"6825_CR12","doi-asserted-by":"publisher","first-page":"2169","DOI":"10.1007\/s00467-013-2540-6","volume":"28","author":"A Zaloszyc","year":"2013","unstructured":"Zaloszyc A, Schaefer B, Schaefer F, Krid S, Salomon R, Niaudet P, Schmitt CP, Fischbach M (2013) Hydration measurement by bioimpedance spectroscopy and blood pressure management in children on hemodialysis. Pediatr Nephrol 28:2169\u20132177. https:\/\/doi.org\/10.1007\/s00467-013-2540-6","journal-title":"Pediatr Nephrol"},{"key":"6825_CR13","doi-asserted-by":"publisher","first-page":"2327","DOI":"10.1007\/s00467-016-3431-4","volume":"31","author":"M Allinovi","year":"2016","unstructured":"Allinovi M, Saleem MA, Burgess O, Armstrong C, Hayes W (2016) Finding covert fluid: methods for detecting volume overload in children on dialysis. Pediatr Nephrol 31:2327\u20132335. https:\/\/doi.org\/10.1007\/s00467-016-3431-4","journal-title":"Pediatr Nephrol"},{"key":"6825_CR14","doi-asserted-by":"publisher","first-page":"541","DOI":"10.1093\/ndt\/gfw037","volume":"32","author":"M Allinovi","year":"2017","unstructured":"Allinovi M, Saleem M, Romagnani P, Nazerian P, Hayes W (2017) Lung ultrasound: a novel technique for detecting fluid overload in children on dialysis. Nephrol Dial Transplant 32:541\u2013547. https:\/\/doi.org\/10.1093\/ndt\/gfw037","journal-title":"Nephrol Dial Transplant"},{"key":"6825_CR15","doi-asserted-by":"publisher","first-page":"85","DOI":"10.5414\/CNP96S15","volume":"96","author":"L Lu\u010di\u010d \u0160rajer","year":"2021","unstructured":"Lu\u010di\u010d \u0160rajer L, Marko K, Vodo\u0161ek Hojs N, Piko N, Bevc S, Hojs R, Ekart R (2021) Lung ultrasound, hemoglobin, and NT-proBNP in peritoneal dialysis patients. Clin Nephrol 96:85\u201388. https:\/\/doi.org\/10.5414\/CNP96S15","journal-title":"Clin Nephrol"},{"key":"6825_CR16","doi-asserted-by":"publisher","first-page":"1564","DOI":"10.1093\/ndt\/11.8.1564","volume":"11","author":"F S\u00f6nmez","year":"1996","unstructured":"S\u00f6nmez F, Mir S, Ozy\u00fcrek AR, Cura A (1996) The adjustment of post-dialysis dry weight based on non-invasive measurements in children. Nephrol Dial Transplant 11:1564\u20131567","journal-title":"Nephrol Dial Transplant"},{"key":"6825_CR17","doi-asserted-by":"publisher","first-page":"1203","DOI":"10.1093\/ndt\/16.6.1203","volume":"16","author":"I Krause","year":"2001","unstructured":"Krause I, Birk E, Davidovits M, Cleper R, Blieden L, Pinhas L, Gamzo Z, Eisenstein B (2001) Inferior vena cava diameter: a useful method for estimation of fluid status in children on haemodialysis. Nephrol Dial Transplant 16:1203\u20131206. https:\/\/doi.org\/10.1093\/ndt\/16.6.1203","journal-title":"Nephrol Dial Transplant"},{"key":"6825_CR18","doi-asserted-by":"publisher","first-page":"135","DOI":"10.1111\/j.1440-1797.2006.00700.x","volume":"12","author":"P Haciomeroglu","year":"2007","unstructured":"Haciomeroglu P, Ozkaya O, Gunal N, Baysal K (2007) Venous collapsibility index changes in children on dialysis. Nephrology (Carlton) 12:135\u2013139. https:\/\/doi.org\/10.1111\/j.1440-1797.2006.00700.x","journal-title":"Nephrology (Carlton)"},{"key":"6825_CR19","doi-asserted-by":"publisher","first-page":"373","DOI":"10.1186\/s12882-017-0793-1","volume":"18","author":"X Torter\u00fce","year":"2017","unstructured":"Torter\u00fce X, Dehoux L, Macher MA, Niel O, Kwon T, Desch\u00eanes G, Hogan J (2017) Fluid status evaluation by inferior vena cava diameter and bioimpedance spectroscopy in pediatric chronic hemodialysis. BMC Nephrol 18:373. https:\/\/doi.org\/10.1186\/s12882-017-0793-1","journal-title":"BMC Nephrol"},{"key":"6825_CR20","doi-asserted-by":"publisher","first-page":"3057","DOI":"10.1007\/s00467-024-06409-2","volume":"39","author":"FI Fadel","year":"2024","unstructured":"Fadel FI, Salah DM, Mawla MAA, Galal E, Sayed S (2024) Assessment of volume status of pediatric hemodialysis patients. Pediatr Nephrol 39:3057\u20133066. https:\/\/doi.org\/10.1007\/s00467-024-06409-2","journal-title":"Pediatr Nephrol"},{"key":"6825_CR21","doi-asserted-by":"publisher","first-page":"410","DOI":"10.1186\/s12882-022-03044-7","volume":"23","author":"GFL Tan","year":"2022","unstructured":"Tan GFL, Du T, Liu JS, Chai CC, Nyein CM, Liu AYL (2022) Automated lung ultrasound image assessment using artificial intelligence to identify fluid overload in dialysis patients. BMC Nephrol 23:410. https:\/\/doi.org\/10.1186\/s12882-022-03044-7","journal-title":"BMC Nephrol"}],"container-title":["Pediatric Nephrology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00467-025-06825-y.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00467-025-06825-y\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00467-025-06825-y.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,1]],"date-time":"2025-10-01T00:06:17Z","timestamp":1759277177000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s00467-025-06825-y"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,7,3]]},"references-count":21,"journal-issue":{"issue":"11","published-print":{"date-parts":[[2025,11]]}},"alternative-id":["6825"],"URL":"https:\/\/doi.org\/10.1007\/s00467-025-06825-y","relation":{},"ISSN":["0931-041X","1432-198X"],"issn-type":[{"value":"0931-041X","type":"print"},{"value":"1432-198X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,7,3]]},"assertion":[{"value":"11 February 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"20 April 2025","order":2,"name":"revised","label":"Revised","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"9 May 2025","order":3,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"3 July 2025","order":4,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"All procedures involving human participants were performed in accordance with the ethical standards of the institutional and\/or national research committee, in addition to the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards. The study was approved by the \u00c7ukurova University Faculty of Medicine Non-Interventional Clinical Research Ethics Committee (Approval no: 05.11.2021\u2013116\/4).","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval"}},{"value":"The authors declare no competing interests.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}]}}