Lung Ultrasound in Hemodialysis: A Card to be Played?

The end-stage renal disease is characterized by a profound impairment in the regulation of body fluid distribution, and volume assessment in hemodialysis is one of the challenging goals for the nephrologist. To determine a state of euvolemia, different validated techniques have been employed and among them lung ultrasonography (LUS) has recently attracted growing attention on account of its capacity to estimate accurately extra vascular lung water and to detect lung edema even in its early asymptomatic stage, that is, hidden lung congestion.With its noninvasiveness, freedom from radiation, the ease of use, acceptable intra/inter-operator reproducibility and availability of portable ultrasound devices, LUS can be considered one of the most interesting "cards to play" for the volume assessment in patients on hemodialysis.