{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T16:24:32Z","timestamp":1791563072994,"version":"4.3.4"},"reference-count":50,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"1","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":["Kidney360"],"published-print":{"date-parts":[[2022,1]]},"abstract":"<jats:p>Volume overload, and its attendant increase in acute care utilization and cardiovascular morbidity and mortality, represents a critical challenge for the practicing nephrologist. This is particularly true among patients with ESKD on HD, where predialysis volume overload and intradialytic and postdialytic hypovolemia account for almost a third of all cost for the Medicare dialysis benefit. Quantitative lung ultrasound is a tool for assessing the extent of extravascular lung water that outperforms physical exam and plain chest radiography. B-lines are vertical hyperechoic artifacts present in patients with increased extravascular lung water. B-lines have been shown to decrease dynamically during the hemodialysis treatment in proportion to ultrafiltration volume. Among patients with chronic heart failure, titration of diuretics on the basis of the extent of pulmonary congestion noted on lung ultrasonography has been shown to decrease recurrent acute care utilization. Early data from randomized controlled trials of lung ultrasound\u2013guided ultrafiltration therapy among patients with ESKD on HD have shown promise for potential reduction in recurrent episodes of decompensated heart failure and cardiovascular events. Ultimately, lung ultrasound may predict those who are ultrafiltration tolerant and could be used to decrease acute care utilization and, thus, cost in this population.<\/jats:p>","DOI":"10.34067\/kid.0003972021","type":"journal-article","created":{"date-parts":[[2021,11,11]],"date-time":"2021-11-11T14:10:11Z","timestamp":1636639811000},"page":"176-184","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":20,"title":["Quantitative Lung Ultrasonography for the Nephrologist: Applications in Dialysis and Heart Failure"],"prefix":"10.34067","volume":"3","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8054-2579","authenticated-orcid":false,"given":"Nathaniel","family":"Reisinger","sequence":"first","affiliation":[{"name":"Perelman School of Medicine, Hospital of the University of Pennsylvania, Division of Renal, Electrolyte and Hypertension, University of Pennsylvania, Philadelphia, Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5801-3574","authenticated-orcid":false,"given":"Abhilash","family":"Koratala","sequence":"additional","affiliation":[{"name":"Division of Nephrology, Medical College of Wisconsin, Milwaukee, Wisconsin"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2022,1,27]]},"reference":[{"key":"B1-20250825","doi-asserted-by":"crossref","first-page":"343","DOI":"10.1016\/j.ekir.2017.10.014","article-title":"Potentially avoidable readmissions in United States hemodialysis patients","volume":"3","author":"Mathew","year":"2017","journal-title":"Kidney Int Rep"},{"key":"B2-20250825","doi-asserted-by":"crossref","first-page":"2491","DOI":"10.1681\/ASN.2016121341","article-title":"Chronic fluid overload and mortality in ESRD","volume":"28","author":"Zoccali","year":"2017","journal-title":"J Am Soc Nephrol"},{"key":"B3-20250825","doi-asserted-by":"crossref","first-page":"A6","DOI":"10.1053\/j.ajkd.2019.09.003","article-title":"US Renal Data System 2019 Annual Data Report: Epidemiology of Kidney Disease in the United States","volume":"75","author":"Saran","year":"2020","journal-title":"Am J Kidney Dis"},{"key":"B4-20250825","doi-asserted-by":"crossref","first-page":"1054","DOI":"10.2215\/CJN.00340110","article-title":"Hospital treatment for fluid overload in the Medicare hemodialysis population","volume":"5","author":"Arneson","year":"2010","journal-title":"Clin J Am Soc Nephrol"},{"key":"B5-20250825","doi-asserted-by":"crossref","first-page":"6","DOI":"10.1111\/sdi.12559","article-title":"Lung ultrasound in the management of fluid volume in dialysis patients: Potential usefulness","volume":"30","author":"Zoccali","year":"2017","journal-title":"Semin Dial"},{"key":"B6-20250825","doi-asserted-by":"crossref","first-page":"2005","DOI":"10.2215\/CJN.03890416","article-title":"The agreement between auscultation and lung ultrasound in hemodialysis patients: The LUST study","volume":"11","author":"Torino","year":"2016","journal-title":"Clin J Am Soc Nephrol"},{"key":"B7-20250825","doi-asserted-by":"crossref","first-page":"153","DOI":"10.2215\/CJN.03650807","article-title":"On the importance of pedal edema in hemodialysis patients","volume":"3","author":"Agarwal","year":"2008","journal-title":"Clin J Am Soc Nephrol"},{"key":"B8-20250825","doi-asserted-by":"crossref","first-page":"e190703","DOI":"10.1001\/jamanetworkopen.2019.0703","article-title":"Diagnostic accuracy of point-of-care lung ultrasonography and chest radiography in adults with symptoms suggestive of acute decompensated heart failure: A systematic review and meta-analysis","volume":"2","author":"Maw","year":"2019","journal-title":"JAMA Netw Open"},{"key":"B9-20250825","doi-asserted-by":"crossref","first-page":"1640","DOI":"10.1164\/ajrccm.156.5.96-07096","article-title":"The comet-tail artifact. 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