Seeing through the myths: Practical aspects of diagnostic point-of-care ultrasound in nephrology

Abstract

Point of care ultrasonography (POCUS) is emerging as an invaluable tool for guiding patient care at the bedside, providing real-time diagnostic information to clinicians. Today, POCUS is recognized as the fifth pillar of bedside clinical examination, alongside inspection, palpation, percussion, and auscultation. In spite of growing interest, the adoption of diagnostic POCUS in nephrology remains limited, and comprehensive training beyond kidney ultrasound is offered in only a few fellowship programs. Moreover, several misconceptions and barriers surround the integration of POCUS into day-to-day nephrology practice. These include myths about its scope, utility, impact on patient outcomes and legal implications. In this minireview, we address some of these issues to encourage wider and proper utilization of POCUS.

Keywords: Ultrasound; Point of care ultrasonography; Doppler; Congestion; Hemodynamics; Nephrology

Core Tip: Nephrologists frequently encounter challenges in assessing fluid volume status in their daily practice, and point of care ultrasonography (POCUS) can significantly enhance the sensitivity of traditional physical examination in such scenarios. Not only does POCUS aid in swift diagnosis, but it also reduces fragmentation of care. While it may obviate the need for additional imaging studies in specific cases, it should not be considered a replacement for comprehensive consultative imaging. The effectiveness of POCUS largely relies on the proficiency and experience of the operator, which, in turn, is influenced by the quality of training provided.