Lung ultrasound in nephrology: Basics, applications, limitations, and future directions

doi:10.5527/wjn.v14.i4.110491

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Dec 25, 2025 (publication date) through Mar 2, 2026

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World Journal of Nephrology

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2220-6124

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World J Nephrol. Dec 25, 2025; 14(4): 110491
Published online Dec 25, 2025. doi: 10.5527/wjn.v14.i4.110491

Lung ultrasound in nephrology: Basics, applications, limitations, and future directions

Naga Sai Akhil Reddy Gogula, Abhilash Koratala

Naga Sai Akhil Reddy Gogula, Molecular Physiology Institute, Duke University School of Medicine, Durham, NC 27710, United States

Abhilash Koratala, Division of Nephrology, Medical College of Wisconsin, Milwaukee, WI 53226, United States

Author contributions: Gogula NSAR conducted an independent literature review and drafted the initial manuscript; Koratala A critically reviewed and revised the manuscript for intellectual content.

Conflict-of-interest statement: All authors declare that they have no conflict of interest to disclose.

Corresponding 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. akoratala@mcw.edu

Received: June 9, 2025
Revised: July 12, 2025
Accepted: November 5, 2025
Published online: December 25, 2025
Processing time: 199 Days and 7.4 Hours

Core Tip

Core Tip: Point-of-care ultrasonography, especially lung ultrasound (LUS), is becoming an essential bedside tool in nephrology. 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, cardiac, and venous Doppler ultrasound ensures a more accurate hemodynamic picture.