Hand-carried ultrasound use in clinical nephrology: Case report

BACKGROUND: Correctly assessing and managing volume status are critical elements of daily care for patients managed by nephrologists. However, intravascular volume is difficult to assess by physical examination alone. METHODS: We present vignettes illustrating the potential for using hand-carried ultrasound (HCU) to improve volume assessment in common clinical scenarios faced by the renal consultant in the hospital setting. These include patients with acute kidney injury and patients treated with hemodialysis. RESULTS: We used HCU to provide essential information about volume status which is otherwise not readily available. HCU allowed objective assessment of volume status, helping with clinical management of hospitalized patients and potentially avoiding harm. CONCLUSION: HCU can complement physical examination for volume assessment in hospitalized patients with acute kidney injury or those on hemodialysis. Our report highlights the need for systematic research in this area.