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Blood Purif. 2019 Oct 9:1-5. doi: 10.1159/000503000. [Epub ahead of print]

Point-of-Care Ultrasonography for Objective Volume Management in End-Stage Renal Disease.

Author information

1
Division of Nephrology, Hypertension and Renal Transplantation, University of Florida, Gainesville, Florida, USA, koratala@uthscsa.edu.
2
Division of Nephrology, University of Texas at San Antonio, San Antonio, Texas, USA, koratala@uthscsa.edu.
3
Division of Nephrology, Hypertension and Renal Transplantation, University of Florida, Gainesville, Florida, USA.

Abstract

Focused ultrasonography or point-of-care ultrasonography (POCUS) is increasingly considered as an essential bedside diagnostic tool. In patients with end-stage renal disease (ESRD) treated with hemodialysis, it can be used as an adjunct to physical examination to objectively assess the volume status and guide the rate and amount of ultrafiltration. Herein, we describe the case of an ESRD patient presenting with hypertensive urgency where POCUS disclosed the presence of hypervolemia despite unremarkable physical examination. The sonographic findings of the inferior vena cava, heart, and lungs guided fluid extraction during hemodialysis therapy, and the actual ultrafiltration volume was significantly higher than what was anticipated based on clinical findings. This case highlights the importance of using -POCUS as a tool for objective and precise assessment of volume status in patients with ESRD.

KEYWORDS:

Dialysis; Echocardiography; Inferior vena cava; Lung; Point-of-care ultrasonography; Ultrafiltration

PMID:
31597153
DOI:
10.1159/000503000

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