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. 2024 Mar;27(1):67-71.
doi: 10.1007/s40477-023-00802-7. Epub 2023 Aug 1.

The value of venous system ultrasound in predicting the need for emergency haemodialysis in haemodialysis patients

Mehmet Ali Aslaner  1 , Özant Helvacı  2 , Mahi Nur Cerit  3 , Halit Nahit Şendur  3
Affiliations

The value of venous system ultrasound in predicting the need for emergency haemodialysis in haemodialysis patients

Mehmet Ali Aslaner et al. J Ultrasound. 2024 Mar.

Abstract

Background: Emergency haemodialysis (HD) is a therapeutic procedure performed in serious clinical situations. This study investigated venous Doppler ultrasound parameters for predicting emergency HD in patients on routine HD treatment for end-stage renal disease in the emergency department (ED).

Method: Adult patients on a routine HD program in a tertiary care ED between April and December 2022 were enrolled in the study. Inferior vena cava, hepatic, and portal vein flow parameters and the venous excess ultrasound (VExUS) score calculated from these parameters were noted in order to predict emergency HD indications. Hyperkalaemia, hypervolemia, missing more than one session, uremic findings, and metabolic acidosis were regarded as emergency HD indications.

Results: One hundred twenty-nine venous ultrasound examinations were performed on 43 patients with routine HD during the study period. The rate of emergency HD was 30.2%. The most common indication of it was hypervolemia (76.9%), followed by missing more than one session (23.1%). Only the portal vein had an AUC value of 0.714, with a sensitivity of 61.5% and specificity of 83.3% for predicting emergency HD. Other parameters including the IVC, hepatic vein, and VExUS score were of no diagnostic value.

Conclusion: The findings of this study show that only the portal vein Doppler flow parameter has very limited diagnostic value for emergency HD in patients on a routine HD program in the ED. This study can serve as a guide to further research.

Keywords: Emergency department; Haemodialysis; VExUS; Venous Doppler.

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Conflict of interest statement

The authors have no relevant financial or non-financial interests to disclose.

Figures

Fig. 1
Fig. 1
Normal and abnormal venous Doppler patterns of VExUS score
See this image and copyright information in PMC

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