[Pulmonary congestion and hypertension in hemodialysis patients]

Mild to moderate volume expansion is a frequent complication in dialysis patients and acute volume overload, such as acute pulmonary oedema, is one of the most worrying medical emergency in these patients. Estimated systolic blood pressure in the pulmonary artery (ePASP) is an important risk factor of mortality and cardiovascular (CV) events in the general population and in patients on dialysis. Therefore, the assessment of body water in dialysis patients is useful both from the clinical point of view for monitoring fluids as well as for prognostic purposes. However, there is still debated about what is the most suitable instrument to measure the circulating volume in clinical practice in dialysis patients. Pulmonary ultrasound is a new application of ultrasound to evaluate the content of water in the lungs and it has been recently used in high risk patients. The B-lines are a promising technique that has to be properly tested before being used and appropriately implemented in everyday clinical practice.