Abbreviated Point-of-Care-Ultrasound Volume Assessment for Outpatient Hemodialysis Patients.
- 1Division of Nephrology and Hypertension, Mayo Clinic, Jacksonville, FL.
- 2Division of Clinical Trial and Biostatistics (M.G.H., Z.F.), Mayo Clinic, Jacksonville, FL.
Abstract
Objective
To evaluate the safety and feasibility of an abbreviated lung and inferior vena cava (IVC) point-of-care ultrasound (POCUS) protocol for outpatient hemodialysis volume assessment when compared with standard practice.Patients and methods
In this prospective case-control study, adults receiving long-term in-center hemodialysis underwent abbreviated POCUS-assisted assessment (n=15, 34%) or standard clinical assessment (non-POCUS, n=29, 66%). POCUS was performed during dialysis using a 6-zone lung ultrasound protocol with IVC assessment. Hypervolemia was defined as ≥3 B lines in ≥2 lung zones with bilateral involvement or an IVC diameter ≥2.1 cm with <50% collapsibility. The primary outcome was change in estimated dry weight (EDW) guided by POCUS when compared with standard clinical assessment. Secondary outcomes included falls, all-cause and hypervolemia-related hospitalizations, antihypertensive medication changes, and mortality.Results
All POCUS participants (15/15, 100%) met hypervolemia criteria at the initial assessment and underwent EDW reduction; 46.7% met criteria at repeat assessment. Median POCUS examination time was 6 minutes (range 4-10). Reductions in prescribed EDW occurred more frequently in the POCUS group (100% vs 41.4%). Postdialysis weight remained higher relative to new prescribed EDW in the POCUS group at study end. No significant differences were observed in intradialytic blood pressure (P=.24), falls (P=.98), or hospitalizations (P=.67), and no hypervolemia-related hospitalizations (P=.54) occurred in the POCUS group.Conclusion
An abbreviated 6-zone lung and IVC POCUS protocol is feasible and safe in outpatient hemodialysis and prompts earlier EDW adjustment. Larger randomized studies are needed to determine its impact on sustained volume control and clinical outcomes.
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BibTeX
@article{ritchie2026abbreviated,
title = {{Abbreviated Point-of-Care-Ultrasound Volume Assessment for Outpatient Hemodialysis Patients.}},
author = {Leanna V Ritchie and Michael G Heckman and Zhihui Fang and Lyle W Baker and Fouad T Chebib and LaTonya J Hickson and Sandhya Manohar and Ivan E Porter and Nabeel Aslam and Christopher L Trautman and Michael A Mao},
journal = {Mayo Clinic proceedings. Innovations, quality \& outcomes},
year = {2026},
month = oct,
doi = {10.1016/j.mayocpiqo.2026.100766},
url = {https://europepmc.org/article/MED/42898390},
note = {CC BY},
}
RIS
TY - JOUR
TI - Abbreviated Point-of-Care-Ultrasound Volume Assessment for Outpatient Hemodialysis Patients.
AU - Leanna V Ritchie
AU - Michael G Heckman
AU - Zhihui Fang
AU - Lyle W Baker
AU - Fouad T Chebib
AU - LaTonya J Hickson
AU - Sandhya Manohar
AU - Ivan E Porter
AU - Nabeel Aslam
AU - Christopher L Trautman
AU - Michael A Mao
PY - 2026
DA - 2026/10/09
JO - Mayo Clinic proceedings. Innovations, quality & outcomes
DO - 10.1016/j.mayocpiqo.2026.100766
UR - https://europepmc.org/article/MED/42898390
AB - Objective To evaluate the safety and feasibility of an abbreviated lung and inferior vena cava (IVC) point-of-care ultrasound (POCUS) protocol for outpatient hemodialysis volume assessment when compared with standard practice.Patients and methods In this prospective case-control study, adults receiving long-term in-center hemodialysis underwent abbreviated POCUS-assisted assessment (n=15, 34%) or standard clinical assessment (non-POCUS, n=29, 66%). POCUS was performed during dialysis using a 6-zone lung ultrasound protocol with IVC assessment. Hypervolemia was defined as ≥3 B lines in ≥2 lung zones with bilateral involvement or an IVC diameter ≥2.1 cm with <50% collapsibility. The primary outcome was change in estimated dry weight (EDW) guided by POCUS when compared with standard clinical assessment. Secondary outcomes included falls, all-cause and hypervolemia-related hospitalizations, antihypertensive medication changes, and mortality.Results All POCUS participants (15/15, 100%) met hypervolemia criteria at the initial assessment and underwent EDW reduction; 46.7% met criteria at repeat assessment. Median POCUS examination time was 6 minutes (range 4-10). Reductions in prescribed EDW occurred more frequently in the POCUS group (100% vs 41.4%). Postdialysis weight remained higher relative to new prescribed EDW in the POCUS group at study end. No significant differences were observed in intradialytic blood pressure (P=.24), falls (P=.98), or hospitalizations (P=.67), and no hypervolemia-related hospitalizations (P=.54) occurred in the POCUS group.Conclusion An abbreviated 6-zone lung and IVC POCUS protocol is feasible and safe in outpatient hemodialysis and prompts earlier EDW adjustment. Larger randomized studies are needed to determine its impact on sustained volume control and clinical outcomes.
SN - 2542-4548
ER -