Lung ultrasound can efficiently diagnose volume overload in hemodialysis patients

Pulmonary congestion owing to fluid overload is common among patients with kidney failure on hemodialysis (HD) and contributes to excess morbidity and mortality in this population. Physical examination is an insensitive approach to detecting pulmonary congestion. Previous studies have shown that 28-zone lung ultrasound is a sensitive test for detecting pulmonary congestion that is associated with adverse clinical outcomes. It is unknown whether abbreviated forms of lung ultrasound tests examining fewer than 28 zones have similar diagnostic sensitivity. In this comparative study published in the American Journal of Kidney Diseases (AJKD), Nathaniel Reisinger et al found that several abbreviated lung ultrasound protocols (4, 6, or 8-zone) performed similarly to 28-zone studies among patients with kidney failure on hemodialysis seeking care in an emergency department. The researchers did not demonstrate mortality differences between those with no-to-mild and moderate-to-severe pulmonary congestion. These data suggest that abbreviated lung ultrasound may be useful for expeditious evaluation of pulmonary congestion.