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In nephrology, lung ultrasound (LUS) supports assessment of extravascular lung water and fluid management, particularly in end-stage renal disease. This narrative review summarizes current applications, technical considerations, and limitations. Evidence from the Lung Water by Ultrasound-Guided Treatment in Haemodialysis Patients trial suggests LUS-guided ultrafiltration may improve blood pressure control and reduce pulmonary congestion and acute heart failure events.",{"@graph":69,"@context":122},[70,84,105],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/lung-ultrasound-in-nephrology-basics-applications-limitations-and-future-directions/406690/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/lung-ultrasound-in-nephrology-basics-applications-limitations-and-future-directions/406690.png","ImageObject",300,407,{"name":92,"@type":93},"4398046744996","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-10-30","2026-09-28",true,{"@type":102,"interactionType":103,"userInteractionCount":52},"InteractionCounter",{"@type":104},"ViewAction",{"@type":106,"mainEntity":107},"FAQPage",[108,114,118],{"name":109,"@type":110,"acceptedAnswer":111},"What role does lung ultrasound play in nephrology?","Question",{"text":112,"@type":113},"Lung ultrasound (LUS) is used to assess extravascular lung water and to guide fluid management, especially in end-stage renal disease patients.","Answer",{"name":115,"@type":110,"acceptedAnswer":116},"Which clinical benefit is associated with LUS-guided ultrafiltration in dialysis?",{"text":117,"@type":113},"Studies such as the LUST trial suggest LUS-guided ultrafiltration may help improve blood pressure control and reduce pulmonary congestion and acute heart failure events.",{"name":119,"@type":110,"acceptedAnswer":120},"What limitations should be considered when using LUS alone?",{"text":121,"@type":113},"Limitations include reduced specificity in non-cardiogenic lung conditions and under-recognition of right-sided congestion when LUS is used in isolation.","https://schema.org",{"og:url":83,"og:type":124,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":126,"canonical":83},"index,follow",{"doc_id":128,"site_id":62},406690,1790789723,{"code":4,"msg":5,"data":131},{"doc_id":128,"user_id":132,"nickname":92,"user_avatar":66,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":133,"file_id":134,"file_url":135,"file_type":136,"file_size":137,"view_count":52,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":138,"language":139,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":140,"faqs":141,"seo_title":142,"seo_description":67,"update_tm":143,"read_time":144,"preview_page_count":4},4398046744996,"| W | J | N | World Journal of\u003Cbr>Nephrology |\n| --- | --- | --- | --- |\n\nSubmit a Manuscript: [https://www.f6publishing.com](https://www.f6publishing.com) World J Nephrol 2025 December 25; 14(4): 110491  \nDOI: 10.5527/wjn.v14.i4.110491 ISSN 2220-6124 (online)  \nMINIREVIEWS  \nLung ultrasound in nephrology: Basics, applications, limitations, and future directions  \nNaga Sai Akhil Reddy Gogula, Abhilash Koratala  \nSpecialty type: Urology and nephrology  \nProvenance and peer review:  \nInvited article; Externally peer reviewed.  \nPeer-review model: Single blind  \nPeer-review report’s classification Scientific Quality: Grade B  \nNovelty: Grade A  \nCreativity or Innovation: Grade B  \nScientific Significance: Grade A  \nP-Reviewer: Chin WV, MD, MRCP, Consultant, Malaysia  \nReceived: June 9, 2025  \nRevised: July 12, 2025  \nAccepted: November 5, 2025  \nPublished online: December 25, 2025  \nProcessing time: 199 Days and 6.7 Hours  \nNaga Sai Akhil Reddy Gogula, Molecular Physiology Institute, Duke University School of Medicine, Durham, NC 27710, United States  \nAbhilash Koratala, Division of Nephrology, Medical College of Wisconsin, Milwaukee, WI 53226, United States  \nCorresponding author: Abhilash Koratala, Associate Professor, Senior Researcher, Division of Nephrology, Medical College of Wisconsin, 8701 W Watertown Plank Road, Room A 7633, Milwaukee, WI 53226, [United States.](United States. akoratala@mcw.edu)[ akoratala@mcw.edu](United States. akoratala@mcw.edu)  \nAbstract  \nPoint-of-care ultrasonography (POCUS) is increasingly recognized as a valuable extension of the physical exam, offering real-time bedside insights to support clinical decision-making. In nephrology, lung ultrasound (LUS) is gaining prominence for its ability to assess extravascular lung water and guide fluid management, especially in patients with end-stage renal disease. This narrative review highlights current applications, technical aspects, and limitations of LUS in nephrology. Studies such as the Lung Water by Ultrasound-Guided Treatment in Haemodialysis Patients trial indicate that LUS-guided ultrafiltration may help improve blood pressure control, reduce pulmonary congestion and acute heart failure events in dialysis patients. Simplified approaches like the 8-zone protocol have shown diagnostic accuracy comparable to the traditional 28-zone method, improving feasibility in clinical practice. Nonetheless, limitations exist, including reduced specificity in non-cardiogenic lung conditions and under recognition of right-sided congestion when used in isolation. A comprehensive hemodynamic assessment requires integrating LUS with inferior vena cava ultrasound, focused cardiac ultrasound, and venous Doppler. Successful implementation depends on structured training and an understanding of potential interpretation challenges. Looking ahead, streamlined protocols, multimodal integration, and standardized training will be key to establishing POCUS as a core tool in nephrology.  \nKey Words: Point-of-care ultrasonography; Ultrasound; B-lines; Nephrology; Dialysis; Heart failure  \n©The Author(s) 2025. Published by Baishideng Publishing Group Inc. All rights reserved.  \n WJN  [https://www.wjgnet.com](https://www.wjgnet.com) 1 December 25, 2025  Volume 14  Issue 4   \nGogula NSAR et al. Lung ultrasound in nephrology  \nCore Tip: Point-of-care ultrasonography, especially lung ultrasound (LUS), is becoming an essential bedside tool innephrology. It enables dynamic, noninvasive assessment of fluid status and extravascular lung water, particularly in dialysis patients. Evidence from trials like Lung Water by Ultrasound-Guided Treatment in Haemodialysis Patients highlights its potential to guide ultrafiltration, improve blood pressure control, and reduce heart failure events. Simplified protocols, such as 8-zone LUS, offer diagnostic efficiency with greater feasibility. However, LUS should not be used in isolation. Combining it with other modalities like inferior vena cava, card","cbCaiscmcsOuwX29","https://ap.wps.com/l/cbCaiscmcsOuwX29","pdf",5115097,11,"English","# MINIREVIEWS\n## Lung ultrasound in nephrology: Basics, applications, limitations, and future directions\n## Abstract\n## Core Tip\n## Introduction","[{\"question\":\"What role does lung ultrasound play in nephrology?\",\"answer\":\"Lung ultrasound (LUS) is used to assess extravascular lung water and to guide fluid management, especially in end-stage renal disease patients.\"},{\"question\":\"Which clinical benefit is associated with LUS-guided ultrafiltration in dialysis?\",\"answer\":\"Studies such as the LUST trial suggest LUS-guided ultrafiltration may help improve blood pressure control and reduce pulmonary congestion and acute heart failure events.\"},{\"question\":\"What limitations should be considered when using LUS alone?\",\"answer\":\"Limitations include reduced specificity in non-cardiogenic lung conditions and under-recognition of right-sided congestion when LUS is used in isolation.\"}]","Lung ultrasound in nephrology - Basics, applications, limitations, and future directions | PDF",1790567310,28]