COVID-19 is a viral disease due to the infection of the novel Corona virus SARS-CoV-2, that has rapidly spread in many countries until the World Health Organization declared the pandemic from March 11, 2020. Elderly patients and those affected by hypertension, diabetes mellitus, and chronic pulmonary and cardiovascular conditions are more susceptible to present more severe forms of COVID-19. These conditions are often represented in dialytic renal end-stage patients. Moreover, dialysis patients are more vulnerable to infection due to suppression of the immune system. Growing evidences, although still supported by few publications, are showing the potential utility of ultrasound in patients with COVID-19. In this review, we share our experience in using point-of-care ultrasound, particularly lung ultrasound, to indicate the probability of COVID-19 in patients with end-stage renal disease treated by hemodialysis. We also propose recommendations for the application of lung ultrasound, focused echocardiography and inferior vena cava ultrasound in the management of patients in hemodialysis.

A 16-hour nephrology POCUS training course that was not limited to topics involving the urinary tract enabled the development of skills to obtain images and perform Nephrology procedures. The program developed can be used as a model for learning POCUS in Nephrology.

ObjectivesTo show that medical students can evaluate the internal jugular vein (IJV) and its anatomical variations after rapid and focused training. We also aimed to evaluate the success rate of IJV puncture in simulation following traditional techniques (TTs) and monitored via ultrasound (US).Materials and methodsSix medical students without experience with US were given 4 h of theoretical–practical training in US, and then evaluated the IJV and common carotid artery (CCA) of 105 patients. They also simulated a puncture of the IJV at a demarcated point, where a TT was theoretically performed.ResultsAdequate images were obtained from 95% of the patients; the IJV, on the right side, was more commonly found in the anterolateral position in relation to the CCA (38%). On the left side, the most commonly position observed was the anterior (36%). The caliber of the IJV relative to the CCA greatly varied. The success rate in the IJV puncture simulation, observed with US, by the TTs was 55%.ConclusionThe training of medical students to recognize large neck vessels is a simple, quick, and feasible task and that can be integrated into the undergraduate medical curriculum.

SUMMARY Cardiovascular diseases are important causes of morbidity and mortality in the course of chronic kidney disease (CKD). Diastolic dysfunction (DD) may progress with the clinical manifestation of heart failure, known as heart failure with preserved ejection fraction, a condition that precedes systolic dysfunction. The early identification of DD by echocardiography at the point-of-care before the appearance of symptoms and signs of pulmonary congestion and the implementation of appropriate treatment can improve the prognosis of CKD. This review article briefly addresses DD in kidney disease and presents a practical approach to the echocardiographic diagnosis of DD at the point of care.

Introduction: Point-of-care ultrasonography (US) (POCUS) has been used in several specialties, particularly in medical emergency. Despite the confirmation of its numerous benefits, the use of POCUS is still timid in nephrology. In the present study, we aim to investigate the use of POCUS by Brazilian nephrologists. Methods: A survey carried out among the members of the Brazilian Society of Nephrology, through institutional e-mail, using the SurveyMonkey platform. We included 12 self-administered questions, which answers were given anonymously. Results: It was evident that the majority (64%) of the participants did not have the opportunity to practice US during their nephrological training in their residency, specialization, or even in internships; those with experience with US use the method mainly for implanting central vascular accesses (68%), performing a renal biopsy (58%) and evaluating renal morphology (50%); and the main barriers for nephrologists who do not yet use US are the high price of US machines (26%) and the lack of time to learn about US (23%). Also, POCUS use for examinations of other organs, such as the lung (31%) and heart (18%), which are fundamental in the cardiovascular and volume assessment of patients with kidney diseases, is even more limited. However, 95% of the participants expressed an interest in learning POCUS for use in their medical practice. Conclusion: Most of the Brazilian nephrologists interviewed were not trained in US; however, almost all of the research participants expressed an interest in learning to use POCUS in nephrological practice.