Gómez-Johnson Victor Hugo, López-Gil Salvador, Argaiz Eduardo R, Koratala Abhilash
Nephrology Department, Instituto Nacional de Cardiología, Ignacio Chávez, Mexico City 14080, Mexico.
Tecnológico de Monterrey, Escuela de Medicina y Ciencias de la Salud, Mexico City 64710, Mexico.
Diagnostics (Basel). 2025 Jan 27;15(3):297. doi: 10.3390/diagnostics15030297.
Point-of-care ultrasound (POCUS) has increasingly become an integral part of clinical practice, particularly in nephrology, where its use extends beyond renal assessment to include multi-organ evaluations. Despite challenges such as limited ultrasound training and equipment access, especially in low- and middle-income countries, the adoption of POCUS is steadily rising. This narrative review explores the growing role of multi-organ POCUS in nephrology, with applications ranging from the assessment of congestion phenotypes, cardiorenal syndrome, and hemodynamic acute kidney injury (AKI) to the evaluation of arteriovenous fistulas and electrolyte disorders. In nephrology, POCUS enhances clinical decision making by enabling rapid, bedside evaluations of fluid status, cardiac function, and arteriovenous access. Studies have demonstrated its utility in diagnosing and managing complications such as heart failure, cirrhosis, and volume overload in end-stage renal disease. Additionally, POCUS has proven valuable in assessing hemodynamic alterations that contribute to AKI, particularly in patients with heart failure, cirrhosis, and systemic congestion. This review highlights how integrating ultrasound techniques, including lung ultrasound, venous Doppler, and focused cardiac ultrasound, can guide fluid management and improve patient outcomes. With advancements in ultrasound technology, particularly affordable handheld devices, and the expansion of targeted training programs, the potential for POCUS to become a global standard tool in nephrology continues to grow, enabling improved care in diverse clinical settings.
床旁超声（POCUS）已日益成为临床实践中不可或缺的一部分，尤其是在肾脏病学领域，其应用范围已从肾脏评估扩展到多器官评估。尽管存在诸如超声培训有限和设备获取困难等挑战，特别是在低收入和中等收入国家，但POCUS的采用率仍在稳步上升。本叙述性综述探讨了多器官POCUS在肾脏病学中日益重要的作用，其应用范围涵盖从评估充血表型、心肾综合征和血流动力学急性肾损伤（AKI）到评估动静脉内瘘和电解质紊乱等。在肾脏病学中，POCUS通过能够在床边快速评估液体状态、心脏功能和动静脉通路，增强了临床决策。研究表明其在诊断和管理诸如心力衰竭、肝硬化和终末期肾病中的容量超负荷等并发症方面具有实用性。此外，POCUS已被证明在评估导致AKI的血流动力学改变方面具有价值，特别是在心力衰竭、肝硬化和全身性充血患者中。本综述强调了整合包括肺部超声、静脉多普勒和聚焦心脏超声在内的超声技术如何能够指导液体管理并改善患者预后。随着超声技术的进步，特别是价格实惠的手持设备，以及针对性培训项目的扩展，POCUS成为肾脏病学全球标准工具的潜力持续增长，从而能够在不同临床环境中提供更好的护理。
