Point-of-care ultrasonography in nephrology: Growing applications, misconceptions and future outlook

Figure 4 Venous excess ultrasound grading score. When inferior vena cava has a diameter > 2 cm, hepatic, portal, and rein vein waveforms should be checked. The abnormalities present in these venous Doppler waveforms correlate with the severity of congestion. Hepatic vein Doppler is considered mildly abnormal when the S wave is smaller than the D wave, but still below the baseline; it is considered severely abnormal when the S wave is reversed. Portal vein Doppler is considered mildly abnormal when the pulsatility is 30%-50%, and severely abnormal when it is ≥ 50%. Intrarenal vein Doppler is mildly abnormal when it is pulsatile with distinct S and D components, and severely abnormal when it is monophasic with a D-only pattern. This figure was adapted from NephroPOCUS.com with permission. The corresponding author Koratala A is the owner of the website and copyright holder[60]. See: https://nephropocus.com/about/.