Portal Vein Doppler Parameters as Indicators of Volume Status in Hemodialysis Patients Using Wireless Ultrasound

Accurately assessing fluid status is a critical yet challenging clinical skill. While hypovolemia marked by low blood pressure and poor tissue perfusion is a major concern, hypervolemia can also cause harmful complications. Because there is no single gold standard test, clinicians must master various non-invasive bedside tools to achieve proper fluid balance.

The objective of this study is to investigate the potential clinical value of portal vein (PV) Doppler parameters in assessing volume status and to evaluate the utility of PV Doppler parameters for assessing volume status.  Methods: A cross-sectional study was conducted on 100 Egyptian patients from a dialysis unit. All participants underwent a medical history review, clinical examination, and laboratory tests including complete blood count, liver function tests, kidney function tests, and assessment of Doppler parameters of the PV pre-dialysis and post-dialysis.

The mean age of cases was 42.70 (± 12.25), while the mean age of control subjects was 45.57 (± 10.32), with no statistically significant difference in age between cases and control subjects (p-value 0.24). Female patients represented 48% and male patients 52% in cases, while in control, female subjects accounted for 46.7% and male subjects 53.3%, with no statistically significant difference between cases and control (p-value 0.898). A significant improvement was observed in the PV diameter post-dialysis (p-value 0.004) and pulsatility index (p-value < 0.001). Additionally, there was a significant improvement in the PV waveform (p-value < 0.001).

PV Doppler parameters reflect systemic venous congestion and changes in volume status in hemodialysis patients. Therefore, they can be used to assess pulmonary congestion in this patient population.