{
  "abstract": "Introduction: Clinical examination has limitations in estimating fluid overload in hemodialysis patients. The aim of the present study was to evaluate the impact of target weight optimization using a modified Venous Excess Ultrasonography Score (VExUS) protocol on blood pressure control in euvolemic hemodialysis patients.\n\nMethods: We enrolled clinically euvolemic patients in hemodialysis from ten Spanish centers. Baseline clinical data, bioimpedance, and an extensive panel of cardiac, congestion, and inflammatory biomarkers were collected. Patients with congestion on modified VExUS protocol (excluding intrarenal vessels) underwent protocol-driven ultrafiltration adjustments. Blood pressure, bioimpedance, and biomarkers were reassessed at study completion, and paired statistical analyses were performed.\n\nResults: Among the 72 clinically euvolemic patients included (60% male, mean age 69 ± 18 years), 23 (32%) showed venous congestion on modified VExUS protocol and entered the intervention group and 49 were followed under routine care conditions (reference). Volume values obtained by bioimpedance spectroscopy were similar in the congestion intervention and non-congestion reference groups. After 4 weeks, the intervention group experienced a significant improvement in modified VExUS protocol parameters compared to baseline (2.1 ± 0.5 vs. 1.3 ± 0.5; p < 0.001) and a systolic blood pressure reduction compared with reference group participants (−14 [−37; 4] vs. 4 [−9; 14] mm Hg) (p = 0.025). The reduction in systolic blood pressure was more notable in patients with higher baseline values. There were no differences in hemodialysis tolerance or biomarker changes between intervention and reference group participants.\n\nConclusion: Modified VExUS protocol is a promising tool for evaluating volume overload and optimizing target weight. Its incorporation in the multiparametric assessment of target weight is associated with better blood pressure control.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Nephrology, Hospital Universitario Infanta Leonor, Madrid, Spain",
    "IIS-Fundación Jiménez Díaz UAM, Madrid, Spain",
    "RICORS 2040, Barcelona, Spain",
    "Department of Nephrology, Hospital Universitario de La Princesa, Madrid, Spain",
    "Department of Nephrology, Hospital Universitario de Burgos, Burgos, Spain",
    "Department of Nephrology, Hospital Universitario Infanta Sofía, Madrid, Spain",
    "Department of Nephrology, Hospital Central de la Defensa Gómez Ulla, Madrid, Spain",
    "Department of Nephrology, Hospital General Universitario Gregorio Marañón, Madrid, Spain",
    "Department of Nephrology, Hospital Infanta Cristina, Madrid, Spain",
    "Department of Nephrology, Hospital Universitario Clínico San Carlos, Madrid, Spain",
    "Department of Nephrology, Hospital Universitario Príncipe de Asturias, Madrid, Spain",
    "Department of Nephrology, Hospital General de Segovia, Segovia, Spain",
    "Department of Nephrology, Hospital Nuestra Señora de Sonsoles, Ávila, Spain"
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 18,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Patricia Muñoz Ramos"
    },
    {
      "affs": [
        1,
        2
      ],
      "name": "Alberto Ortiz",
      "orcid": "0000-0002-9805-9523"
    },
    {
      "affs": [
        1,
        2
      ],
      "name": "Ana B. Sanz"
    },
    {
      "affs": [
        3
      ],
      "name": "Martín Giorgi"
    },
    {
      "affs": [
        3
      ],
      "name": "Paloma Ruiz López-Alvarado"
    },
    {
      "affs": [
        4
      ],
      "name": "Irene Oñate"
    },
    {
      "affs": [
        5
      ],
      "name": "Verónica Ruth Mercado"
    },
    {
      "affs": [
        6
      ],
      "name": "José Carlos de La Flor Merino"
    },
    {
      "affs": [
        7
      ],
      "name": "Marco Vaca Gallardo"
    },
    {
      "affs": [
        8
      ],
      "name": "María Lina León-Machado"
    },
    {
      "affs": [
        9
      ],
      "name": "Virginia López de la Manzanara"
    },
    {
      "affs": [
        10
      ],
      "name": "Mohammad Manouchehri"
    },
    {
      "affs": [
        11
      ],
      "name": "Carlos Santos Alonso"
    },
    {
      "affs": [
        1
      ],
      "name": "Susana Carrasco"
    },
    {
      "affs": [
        12
      ],
      "name": "Miguel Ángel Navas Jiménez"
    },
    {
      "affs": [
        0,
        2
      ],
      "name": "Patricia de Sequera"
    },
    {
      "affs": [
        2,
        3
      ],
      "name": "Borja Quiroga"
    },
    {
      "name": "on behalf of the VExHD study collaborators group"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/8bbn6b9jfgrap.bib",
  "cited_by": 0,
  "doi": "10.1159/crm/abtag011",
  "fulltext_url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC13719186/",
  "id": "8bbn6b9jfgrap",
  "issns": [
    "1664-3828",
    "1664-5502"
  ],
  "landing_url": "https://doi.org/10.1159/crm/abtag011",
  "language": "en",
  "licence": "CC-BY-NC-4.0",
  "licence_label": "CC BY-NC 4.0",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by-nc/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "heading",
      "Research Article"
    ],
    [
      "openalex",
      "2727|Dialysis and Renal Disease Management"
    ]
  ],
  "openalex": "W7222304004",
  "pdf_url": "https://karger.com/crm/article-pdf/doi/10.1159/crm/abtag011/4595078/000554850.pdf",
  "pmcid": "PMC13719186",
  "pmid": "42879334",
  "published": "2026-10-15",
  "publisher": null,
  "ris": "https://research.draconitic.com/paper/8bbn6b9jfgrap.ris",
  "sources": [
    {
      "first_seen": "2026-11-02T12:23:03Z",
      "native_id": "PMC13719186",
      "source": "pmc",
      "url": "https://doi.org/10.1159/crm/abtag011"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "journal-openalex:2705|Heart Failure Treatment and Management",
      "subfield": "cardiovascular"
    }
  ],
  "title": "Target Weight Optimization based on a Modified VExUS Protocol in Hemodialysis: The VexHD Prospective Multi-Center Study",
  "title_text": "Target Weight Optimization based on a Modified VExUS Protocol in Hemodialysis: The VexHD Prospective Multi-Center Study",
  "type": "peer-reviewed",
  "updated_at": "2026-11-02T12:23:03Z",
  "url": "https://research.draconitic.com/paper/8bbn6b9jfgrap",
  "venue": "Cardiorenal Medicine",
  "versions": []
}