Internal Jugular Vein Ultrasound for Fluid Status Assessment in Maintenance Haemodialysis: A Prospective Pilot Exploratory Study

Assessment of fluid status in patients receiving maintenance haemodialysis remains challenging. Point-of-care ultrasound (PoCUS) is increasingly used to support bedside evaluation of volume overload. The internal jugular vein (IJV) has been proposed as a potential marker of central venous pressure and systemic congestion. This pilot exploratory study aimed to investigate the feasibility and potential clinical utility of IJV ultrasound in patients undergoing maintenance haemodialysis. We conducted a prospective observational pilot exploratory study including CKD G5D patients undergoing maintenance haemodialysis. Patients with a history of jugular vein thrombosis, those receiving isovolemic dialysis treatments, and those unable to comply with the study protocol were excluded. Immediately before and after a scheduled haemodialysis session, patients underwent PoCUS examination of the internal jugular vein. Thirty-six ultrasonographic parameters were collected and analysed. Correlations between ultrasound parameters and fluid overload (delta from dry weight) were evaluated together with changes between pre- and post-dialysis examinations. Forty-nine patients were enrolled. IJV ultrasound measurements were not significantly influenced by several potential confounders including sex, body size, vascular access type, and the presence of heart failure. Several ultrasonographic parameters were significantly correlated with delta from dry weight. Among these, the Jugular Vein Distension (JVD) ratio showed the strongest association. Multiple parameters demonstrated significant changes between pre- and post-dialysis examinations. In this pilot exploratory study, IJV ultrasound appeared to be a feasible bedside tool for the assessment of fluid status in haemodialysis patients. Larger studies are needed to validate these findings and to determine the clinical utility of IJV-derived indices such as the JVD ratio.