Role of point-of-care ultrasonography in kidney disease management: A single solution for multiple challenges

Table 1 Summarizes the most recent and founding literature supporting point-of-care ultrasound divided by topic field with correlation to the main clinical implications

Topic area	Ref.	Year	Key findings/implications
Critical care guidelines	Díaz-Gómez et al[2]	2025	Updated evidence-based recommendations for CCUS in cardiac arrest, septic shock, acute dyspnea/respiratory failure, volume resuscitation, and cardiogenic shock; focus on patient-important outcomes
Emergency medicine review	Mani et al[3]	2026	Identified 5 main themes: Ultrasound-guided regional anesthesia, POCUS in resuscitation, diagnostic POCUS, AI/technology integration, and governance/administration; strengthens utility across multiple clinical scenarios
Internal medicine curriculum (Delphi 1)	Chockalingam et al[4]	2025	Consensus on 53 POCUS skills (lung 25%, abdominal 23%, procedural 23%, cardiac 17%, MSK 9%, vascular 4%), 14 teaching methods, and 5 evaluation strategies for IM residency programs
Internal medicine curriculum (Delphi 2)	LoPresti et al[5]	2025	First US consensus for core IM residency curriculum: 12 diagnostic and 6 procedural indications, 15 diagnostic applications, 52 specific skill components (e.g., dyspnea, shock, chest pain, thoracentesis)
Pediatric emergency medicine	Lee et al[7]	2024	Enhances diagnostic accuracy in pediatric shock/cardiac arrest; improves procedural safety for nerve blocks, I, IV access; integral to clinical pathways for intussusception and testicular torsion
Nephrology training position statement	Koratala et al[8]	2024	IAPN position statement shifting POCUS from “optional” to a “core competency.” Establishes training modalities, and quality assurance measures for nephrology POCUS; emphasizes international collaboration and standardization
Nephrology core curriculum	Niyyar et al[9]	2024	AJKD Core Curriculum for nephrology POCUS: Acute/chronic kidney disease, cystic disease, urinary obstruction, volume status, kidney biopsy guidance, dialysis access placement/maintenance, transplant evaluation
Primary care training (EFSUMB)	Andersen et al[10]	2025	EFSUMB training recommendations and generic core curriculum for primary care physicians; corresponds to EFSUMB competence level 1; developed through Delphi process
Primary care curriculum (European Delphi)	Andersen et al[11]	2026	European consensus on 40 diagnostic POCUS examinations within 13 anatomical areas for primary care frontline physicians; 95 panelists from 28 countries; 85% showed substantial/moderate agreement
VExUS Score/hemodynamic assessment	Koratala et al[13]	2026	Evaluation of extended VExUS incorporating internal jugular and splenic veins.
VExUS score/hemodynamic assessment	Leyba et al[14]	2026	VExUS detects dynamic changes in volume status before/after hemodialysis; hepatic and portal vein scores improved significantly after fluid removal
VExUS Score/hemodynamic assessment	Borroni et al[15]	2026	Comprehensive review on VExUS valuable prognostic tool in cardiac ICU/HF; predictive performance less consistent in heterogeneous populations; limited evidence for guiding management strategies
Dialysis and access	Chocarro-Haro et al[16]	2025	Systematic review highlighting importance of person-centred management of haemodialysis. Recommends systematic assessment of vascular access and continuous training for nurses and patients
Fluid management	Josa-Laorden et al[23]	2025	Randomized trial comparing POCUS-guided vs standard diuretic titration in heart failure/AKI. Demonstrated reduced hospital readmission and improved renal functional recovery through individualized decongestion.
Nephrology-oriented POCUS education	Sakai et al[35]	2025	Japanese teaching hospital study: POCUS implementation for AKI increased significantly post-training; VExUS use for congestion assessment rose from 0% (2022) to 66.7% (2023); regular lectures and supervising physician training essential
AI integration	Kim et al[36]	2025	Review of 33 papers, reports that AI POCUS AI POCUS is most used in acute care and for targeted cardiac exams; it improves accessibility, simplifies use and expedites care; main uses are biometry, detection of abnormality and probe guidance
AI integration	East et al[37]	2025	AI reduces operator dependency, improves image quality; emerging innovations include autonomous scanning, real-time predictive analytics, tele-ultrasound, and patient-performed imaging
AI integration	Puticiu et al[38]	2026	AI-POCUS aided detection of blunt trauma injury, supporting eFAST standardization and triaging, with automated measurements and pattern recognition. AI–POCUS plays an emerging role in education and training standardization. Long term impact assessment requires prospective studies

AJKD: American Journal of Kidney Disease; AKI: Acute kidney injury; CCUS: Critical care ultrasonography; HF: Heart failure; IAPN: International Alliance for point-of-care ultrasound in Nephrology; ICU: Intensive care unit; VExUS: Venous excess ultrasound; POCUS: Point-of-care ultrasound; AI: Artificial intelligence; MSK: Musculoskeletal; IM: Internal medicine; eFAST: Extended Focal Assessment with Sonography in Trauma; EFSUMB: European Federation of Societies for Ultrasound in Medicine and Biology.