Usefulness of the VExUS Protocol for Dry-Weight Adjustment in Hemodialysis Patients: The Multicenter VExHD Study

The objective of this prospective observational study is to determine the utility of ultrasonographic assessment using the VExUS protocol for dry weight adjustment in clinically euvolemic patients undergoing hemodialysis. The primary hypothesis is that the assessment of venous congestion by ultrasound may help identify patients who can tolerate increased ultrafiltration, thereby improving blood pressure control. The comparison group will consist of patients who do not meet the criteria for venous congestion according to the VExUS protocol. In patients meeting the criteria for venous congestion, the ultrafiltration volume during hemodialysis will be increased.

Inclusion Criteria: * Patients over 18 years of age who are currently on hemodialysis (more than 90 days since the start of the program) * A schedule of three days per week at the centers included in the study * Signed informed consent Exclusion Criteria: * Clinical signs and symptoms of volume overload * Patients with liver disease (liver cirrhosis, steatosis, portal vein thrombosis) * Severe tricuspid regurgitation * Inability to hold one's breath * Obesity