{"id":"https://openalex.org/W7224958521","doi":"https://doi.org/10.36948/ijfmr.2026.v08i05.90729","title":"Evaluation of Bedside Physical Examination Findings and Point-of-Care Ultrasound Markers for Early Detection of Fluid Overload in Patients with Acute Kidney Injury","display_name":"Evaluation of Bedside Physical Examination Findings and Point-of-Care Ultrasound Markers for Early Detection of Fluid Overload in Patients with Acute Kidney Injury","publication_year":2026,"publication_date":"2026-10-29","ids":{"openalex":"https://openalex.org/W7224958521","doi":"https://doi.org/10.36948/ijfmr.2026.v08i05.90729"},"language":"en","primary_location":{"id":"doi:10.36948/ijfmr.2026.v08i05.90729","doi":"https://doi.org/10.36948/ijfmr.2026.v08i05.90729","is_oa":true,"landing_page_url":"https://doi.org/10.36948/ijfmr.2026.v08i05.90729","pdf_url":"https://www.ijfmr.com/papers/2026/5/90729.pdf","source":{"id":"https://openalex.org/S4210207214","display_name":"International Journal For Multidisciplinary Research","issn_l":"2582-2160","issn":["2582-2160"],"is_oa":false,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":null,"host_organization_name":null,"host_organization_lineage":[],"host_organization_lineage_names":[],"type":"journal"},"license":"cc-by-sa","license_id":"https://openalex.org/licenses/cc-by-sa","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"International Journal For Multidisciplinary Research","raw_type":"journal-article"},"volume":null,"type":"article","is_traditional":true,"indexed_in":["crossref"],"open_access":{"is_oa":true,"oa_status":"hybrid","oa_url":"https://www.ijfmr.com/papers/2026/5/90729.pdf","any_repository_has_fulltext":false},"authorships":[{"author_position":"first","author":{"id":"https://openalex.org/A5157588013","display_name":"Mohammed Moinudeen","orcid":null,"observed_orcids":[]},"institutions":[],"countries":[],"is_corresponding":false,"raw_author_name":"Mohammed Moinudeen","raw_affiliation_strings":["MBBS , Duty Medical Officer & Clinical Researcher , Sanjana speciality Hospital , Chennai"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"MBBS , Duty Medical Officer & Clinical Researcher , Sanjana speciality Hospital , Chennai","institution_ids":[]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5160201461","display_name":"Anjali Vivekanand Zare","orcid":null,"observed_orcids":[]},"institutions":[],"countries":[],"is_corresponding":false,"raw_author_name":"Anjali Vivekanand Zare","raw_affiliation_strings":[],"raw_orcid":null,"affiliations":[]},{"author_position":"middle","author":{"id":"https://openalex.org/A5160218417","display_name":"Shahik Khan","orcid":null,"observed_orcids":[]},"institutions":[],"countries":[],"is_corresponding":false,"raw_author_name":"Shahik Khan","raw_affiliation_strings":["FH medical college"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"FH medical college","institution_ids":[]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5160220536","display_name":"Shiri Fatima","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I4405259052","display_name":"S. Tentishev Asian Medical Institute","ror":"https://ror.org/01na2qs84","country_code":"KG","type":"education","lineage":["https://openalex.org/I4405259052"]}],"countries":["KG"],"is_corresponding":false,"raw_author_name":"Shiri Fatima","raw_affiliation_strings":["MBBS , S. Tentishev Asian Medical Institute Kant , Kyrgyzstan"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"MBBS , S. Tentishev Asian Medical Institute Kant , Kyrgyzstan","institution_ids":["https://openalex.org/I4405259052"]}]},{"author_position":"last","author":{"id":"https://openalex.org/A5160220352","display_name":"Ansari Muzammil","orcid":null,"observed_orcids":[]},"institutions":[],"countries":[],"is_corresponding":false,"raw_author_name":"Ansari Muzammil","raw_affiliation_strings":[],"raw_orcid":null,"affiliations":[]}],"institutions":[],"countries_distinct_count":1,"institutions_distinct_count":1,"corresponding_author_ids":[],"corresponding_institution_ids":[],"apc_list":null,"apc_paid":null,"fwci":0.0,"has_fulltext":true,"cited_by_count":0,"citation_normalized_percentile":{"value":0.84687706,"is_in_top_1_percent":false,"is_in_top_10_percent":false},"cited_by_percentile_year":null,"biblio":{"volume":"8","issue":"5","first_page":null,"last_page":null},"is_retracted":false,"is_paratext":false,"is_xpac":false,"primary_topic":{"id":"https://openalex.org/T11738","display_name":"Ultrasound in Clinical Applications","score":0.9965999722480774,"subfield":{"id":"https://openalex.org/subfields/2706","display_name":"Critical Care and Intensive Care Medicine"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},"topics":[{"id":"https://openalex.org/T11738","display_name":"Ultrasound in Clinical Applications","score":0.9965999722480774,"subfield":{"id":"https://openalex.org/subfields/2706","display_name":"Critical Care and Intensive Care Medicine"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T10684","display_name":"Acute Kidney Injury Research","score":0.0017999999690800905,"subfield":{"id":"https://openalex.org/subfields/2727","display_name":"Nephrology"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T11700","display_name":"Hemodynamic Monitoring and Therapy","score":0.000699999975040555,"subfield":{"id":"https://openalex.org/subfields/2746","display_name":"Surgery"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}}],"keywords":[{"id":"https://openalex.org/keywords/acute-kidney-injury","display_name":"acute kidney injury","score":0.9150000214576721},{"id":"https://openalex.org/keywords/fluid-overload","display_name":"fluid overload","score":0.9929999709129333},{"id":"https://openalex.org/keywords/point-of-care-ultrasound","display_name":"point-of-care ultrasound","score":0.9789999723434448},{"id":"https://openalex.org/keywords/inferior-vena-cava-collapsibility","display_name":"inferior vena cava collapsibility","score":0.8519999980926514},{"id":"https://openalex.org/keywords/lung-ultrasound-b-lines","display_name":"lung ultrasound B-lines","score":0.9549999833106995},{"id":"https://openalex.org/keywords/venous-excess-ultrasound","display_name":"venous excess ultrasound","score":0.9369999766349792},{"id":"https://openalex.org/keywords/jugular-venous-distension","display_name":"jugular venous distension","score":0.8230000138282776},{"id":"https://openalex.org/keywords/peripheral-edema","display_name":"peripheral edema","score":0.8650000095367432},{"id":"https://openalex.org/keywords/extravascular-lung-water","display_name":"extravascular lung water","score":0.890999972820282},{"id":"https://openalex.org/keywords/diuretic-resistance","display_name":"diuretic resistance","score":0.9020000100135803},{"id":"https://openalex.org/keywords/fluid-balance","display_name":"fluid balance","score":0.3179999887943268},{"id":"https://openalex.org/keywords/intensive-care-unit-patients","display_name":"intensive care unit patients","score":0.6039999723434448},{"id":"https://openalex.org/keywords/sensitivity-and-specificity","display_name":"sensitivity and specificity","score":0.6909999847412109},{"id":"https://openalex.org/keywords/duration-of-mechanical-ventilation","display_name":"mechanical ventilation duration","score":0.8240000009536743},{"id":"https://openalex.org/keywords/mortality","display_name":"mortality","score":0.8240000009536743}],"concepts":[{"id":"https://openalex.org/C71924100","wikidata":"https://www.wikidata.org/wiki/Q11190","display_name":"Medicine","level":0,"score":0.9244999885559082},{"id":"https://openalex.org/C527108885","wikidata":"https://www.wikidata.org/wiki/Q835153","display_name":"Physical examination","level":2,"score":0.6826000213623047},{"id":"https://openalex.org/C195646399","wikidata":"https://www.wikidata.org/wiki/Q6058580","display_name":"Intravascular volume status","level":3,"score":0.6279000043869019},{"id":"https://openalex.org/C2781309813","wikidata":"https://www.wikidata.org/wiki/Q1320276","display_name":"Hypovolemia","level":2,"score":0.5648999810218811},{"id":"https://openalex.org/C126838900","wikidata":"https://www.wikidata.org/wiki/Q77604","display_name":"Radiology","level":1,"score":0.5536999702453613},{"id":"https://openalex.org/C2780472472","wikidata":"https://www.wikidata.org/wiki/Q424337","display_name":"Acute kidney injury","level":2,"score":0.5467000007629395},{"id":"https://openalex.org/C143753070","wikidata":"https://www.wikidata.org/wiki/Q162564","display_name":"Ultrasound","level":2,"score":0.5030999779701233},{"id":"https://openalex.org/C188816634","wikidata":"https://www.wikidata.org/wiki/Q2113324","display_name":"Prospective cohort study","level":2,"score":0.49309998750686646},{"id":"https://openalex.org/C2910216633","wikidata":"https://www.wikidata.org/wiki/Q745438","display_name":"Inferior vena cava","level":2,"score":0.45730000734329224},{"id":"https://openalex.org/C2779541074","wikidata":"https://www.wikidata.org/wiki/Q185643","display_name":"Renal replacement therapy","level":2,"score":0.38769999146461487},{"id":"https://openalex.org/C126322002","wikidata":"https://www.wikidata.org/wiki/Q11180","display_name":"Internal medicine","level":1,"score":0.38260000944137573},{"id":"https://openalex.org/C24595384","wikidata":"https://www.wikidata.org/wiki/Q17143767","display_name":"Volume overload","level":3,"score":0.37400001287460327},{"id":"https://openalex.org/C178853913","wikidata":"https://www.wikidata.org/wiki/Q1642137","display_name":"Hemodynamics","level":2,"score":0.33340001106262207},{"id":"https://openalex.org/C2776468924","wikidata":"https://www.wikidata.org/wiki/Q857667","display_name":"Pulmonary edema","level":3,"score":0.32429999113082886},{"id":"https://openalex.org/C40993552","wikidata":"https://www.wikidata.org/wiki/Q514654","display_name":"Gold standard (test)","level":2,"score":0.3165999948978424},{"id":"https://openalex.org/C206179267","wikidata":"https://www.wikidata.org/wiki/Q188952","display_name":"Medical history","level":2,"score":0.31619998812675476},{"id":"https://openalex.org/C141071460","wikidata":"https://www.wikidata.org/wiki/Q40821","display_name":"Surgery","level":1,"score":0.3140000104904175},{"id":"https://openalex.org/C2776376669","wikidata":"https://www.wikidata.org/wiki/Q5094647","display_name":"Intensive care unit","level":2,"score":0.3089999854564667},{"id":"https://openalex.org/C144494922","wikidata":"https://www.wikidata.org/wiki/Q6547272","display_name":"Likelihood ratios in diagnostic testing","level":3,"score":0.3061999976634979},{"id":"https://openalex.org/C2908767450","wikidata":"https://www.wikidata.org/wiki/Q736995","display_name":"Superior vena cava","level":2,"score":0.298799991607666},{"id":"https://openalex.org/C2777482430","wikidata":"https://www.wikidata.org/wiki/Q7168709","display_name":"Peripheral edema","level":3,"score":0.2985999882221222},{"id":"https://openalex.org/C2780886150","wikidata":"https://www.wikidata.org/wiki/Q152234","display_name":"Edema","level":2,"score":0.2985000014305115},{"id":"https://openalex.org/C42219234","wikidata":"https://www.wikidata.org/wiki/Q131130","display_name":"Anesthesia","level":1,"score":0.29319998621940613},{"id":"https://openalex.org/C164705383","wikidata":"https://www.wikidata.org/wiki/Q10379","display_name":"Cardiology","level":1,"score":0.29100000858306885},{"id":"https://openalex.org/C2777714996","wikidata":"https://www.wikidata.org/wiki/Q7886","display_name":"Lung","level":2,"score":0.28459998965263367},{"id":"https://openalex.org/C146957229","wikidata":"https://www.wikidata.org/wiki/Q1266915","display_name":"Perfusion","level":2,"score":0.28119999170303345},{"id":"https://openalex.org/C2909352220","wikidata":"https://www.wikidata.org/wiki/Q7168875","display_name":"Abdominal Fluid","level":2,"score":0.28119999170303345},{"id":"https://openalex.org/C201903717","wikidata":"https://www.wikidata.org/wiki/Q1778788","display_name":"Cohort study","level":2,"score":0.2777000069618225},{"id":"https://openalex.org/C46762472","wikidata":"https://www.wikidata.org/wiki/Q178648","display_name":"Peripheral","level":2,"score":0.2743000090122223},{"id":"https://openalex.org/C72563966","wikidata":"https://www.wikidata.org/wiki/Q1303415","display_name":"Cohort","level":2,"score":0.2669000029563904},{"id":"https://openalex.org/C2987404301","wikidata":"https://www.wikidata.org/wiki/Q679690","display_name":"Intensive care","level":2,"score":0.2597000002861023},{"id":"https://openalex.org/C177713679","wikidata":"https://www.wikidata.org/wiki/Q679690","display_name":"Intensive care medicine","level":1,"score":0.2547999918460846},{"id":"https://openalex.org/C35207712","wikidata":"https://www.wikidata.org/wiki/Q190402","display_name":"Central venous pressure","level":4,"score":0.2529999911785126},{"id":"https://openalex.org/C2777202286","wikidata":"https://www.wikidata.org/wiki/Q9609","display_name":"Vein","level":2,"score":0.25290000438690186}],"mesh":[],"locations_count":1,"locations":[{"id":"doi:10.36948/ijfmr.2026.v08i05.90729","doi":"https://doi.org/10.36948/ijfmr.2026.v08i05.90729","is_oa":true,"landing_page_url":"https://doi.org/10.36948/ijfmr.2026.v08i05.90729","pdf_url":"https://www.ijfmr.com/papers/2026/5/90729.pdf","source":{"id":"https://openalex.org/S4210207214","display_name":"International Journal For Multidisciplinary Research","issn_l":"2582-2160","issn":["2582-2160"],"is_oa":false,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":null,"host_organization_name":null,"host_organization_lineage":[],"host_organization_lineage_names":[],"type":"journal"},"license":"cc-by-sa","license_id":"https://openalex.org/licenses/cc-by-sa","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"International Journal For Multidisciplinary Research","raw_type":"journal-article"}],"best_oa_location":{"id":"doi:10.36948/ijfmr.2026.v08i05.90729","doi":"https://doi.org/10.36948/ijfmr.2026.v08i05.90729","is_oa":true,"landing_page_url":"https://doi.org/10.36948/ijfmr.2026.v08i05.90729","pdf_url":"https://www.ijfmr.com/papers/2026/5/90729.pdf","source":{"id":"https://openalex.org/S4210207214","display_name":"International Journal For Multidisciplinary Research","issn_l":"2582-2160","issn":["2582-2160"],"is_oa":false,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":null,"host_organization_name":null,"host_organization_lineage":[],"host_organization_lineage_names":[],"type":"journal"},"license":"cc-by-sa","license_id":"https://openalex.org/licenses/cc-by-sa","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"International Journal For Multidisciplinary Research","raw_type":"journal-article"},"sustainable_development_goals":[{"score":1.0,"display_name":"Good health and well-being","id":"https://metadata.un.org/sdg/3"}],"study_designs":[{"display_name":"Observational Study","id":"https://openalex.org/study-designs/observational-study"}],"awards":[],"funders":[],"has_content":{"pdf":true,"grobid_xml":true},"content_urls":{"pdf":"https://content.openalex.org/works/W7224958521.pdf","grobid_xml":"https://content.openalex.org/works/W7224958521.grobid-xml"},"referenced_works_count":0,"referenced_works":[],"related_works":["https://openalex.org/W7103755965","https://openalex.org/W7118440658","https://openalex.org/W4313706998","https://openalex.org/W4210709516","https://openalex.org/W2765368748","https://openalex.org/W3016105042","https://openalex.org/W4288808854","https://openalex.org/W4396994130","https://openalex.org/W4401254024","https://openalex.org/W4220713807"],"abstract_inverted_index":{"Background:":[0],"Acute":[1],"kidney":[2,344],"injury":[3],"(AKI)":[4],"frequently":[5],"precipitates":[6],"positive":[7],"fluid":[8,12,110,221,338,370],"balance":[9],"and":[10,25,38,45,51,68,99,114,142,172,186,267,301,357,376],"iatrogenic":[11],"overload,":[13,371],"which":[14],"independently":[15],"correlate":[16],"with":[17,84,118,137,284,288,304,342],"prolonged":[18],"mechanical":[19],"ventilation,":[20],"renal":[21,380],"replacement":[22],"therapy":[23],"dependence,":[24],"elevated":[26],"mortality.":[27],"Traditional":[28,226],"bedside":[29],"physical":[30,81,152,227,332],"examination":[31,82,228,333],"markers\u2014such":[32],"as":[33,59,198],"peripheral":[34,240],"edema,":[35,158],"pulmonary":[36,178],"auscultation,":[37],"daily":[39],"body":[40],"weight\u2014exhibit":[41],"notoriously":[42],"low":[43],"sensitivity":[44,234,236,242,264],"specificity":[46,231,238,244,268],"for":[47,105,271,366],"detecting":[48,272],"early":[49,107,367],"interstitial":[50],"intravascular":[52],"congestion.":[53],"Point-of-care":[54],"ultrasound":[55,96,102],"(POCUS)":[56],"has":[57],"emerged":[58],"a":[60,129,263,360],"transformative":[61],"diagnostic":[62,76,252,364],"modality":[63],"allowing":[64],"real-time,":[65],"non-invasive":[66],"hemodynamic":[67],"tissue":[69],"perfusion":[70],"assessment.":[71],"This":[72],"study":[73,125],"evaluates":[74],"the":[75,106,211,308],"efficacy":[77],"of":[78,109,154,265,269,314,369],"combining":[79],"structured":[80],"findings":[83],"comprehensive":[85],"multi-organ":[86,247,348],"POCUS":[87,167,248],"markers,":[88],"including":[89],"inferior":[90,353],"vena":[91,354],"cava":[92,355],"(IVC)":[93],"collapsibility,":[94],"lung":[95,276,351],"(LUS)":[97],"B-lines,":[98],"venous":[100,160,188,295],"excess":[101],"(VExUS)":[103],"grading,":[104],"detection":[108],"overload":[111,195,222],"in":[112,340],"critically":[113],"acutely":[115],"ill":[116],"patients":[117,135,216,341],"AKI.":[119],"Methods:":[120],"A":[121,254],"prospective":[122],"observational":[123],"cohort":[124],"was":[126,196],"conducted":[127],"over":[128],"twelve-month":[130],"period":[131],"involving":[132],"140":[133,212],"adult":[134],"admitted":[136],"confirmed":[138],"AKI":[139,300],"across":[140,181],"medical":[141],"surgical":[143],"intensive":[144],"care":[145],"units.":[146],"Baseline":[147],"clinical":[148,322],"evaluation":[149],"recorded":[150],"traditional":[151,321],"signs":[153],"congestion":[155,296],"(peripheral":[156],"pitting":[157],"jugular":[159],"distension":[161],"[JVD],":[162],"basal":[163],"crackles,":[164],"hepatomegaly).":[165],"Serial":[166],"examinations":[168],"evaluated":[169],"IVC":[170,281],"maximum":[171],"minimum":[173],"diameters,":[174],"respiratory":[175],"collapsibility":[176],"index,":[177],"B-line":[179,257],"scores":[180],"an":[182,305],"8-zone":[183],"scanning":[184],"protocol,":[185],"hepatic-portal-renal":[187],"Doppler":[189],"flow":[190],"patterns":[191,297],"(VExUS":[192],"grading).":[193],"Fluid":[194],"quantified":[197],"cumulative":[199],"percentage":[200],"weight":[201,206,224],"gain":[202],"from":[203],"baseline":[204],"admission":[205],"(threshold":[207],"\u226510%).":[208],"Results:":[209],"Among":[210],"analyzed":[213],"cohorts,":[214],"58":[215],"(41.4%)":[217],"developed":[218],"clinically":[219,273],"significant":[220],"(\u226510%":[223],"gain).":[225],"demonstrated":[229,262],"high":[230,255],"but":[232],"poor":[233],"(JVD":[235],"42.1%,":[237],"88.3%;":[239],"edema":[241],"51.7%,":[243],"74.4%).":[245],"Conversely,":[246],"parameters":[249,334],"exhibited":[250],"superior":[251],"performance.":[253],"LUS":[256],"score":[258],"(>15":[259],"bilateral":[260],"B-lines)":[261],"84.5%":[266],"81.7%":[270],"relevant":[274],"extravascular":[275],"water.":[277],"An":[278],"engorged,":[279],"non-reactive":[280],"(>2.1":[282],"cm":[283],"<50%":[285],"collapsibility)":[286],"combined":[287],"severe":[289],"VExUS":[290,358],"grade":[291],"2":[292],"or":[293],"3":[294],"predicted":[298],"worsening":[299],"diuretic":[302],"resistance":[303],"area":[306],"under":[307],"receiver":[309],"operating":[310],"characteristic":[311],"curve":[312],"(AUROC)":[313],"0.89":[315],"(95%":[316],"CI,":[317],"0.84\u20130.94),":[318],"significantly":[319],"outperforming":[320],"assessment":[323],"alone":[324],"(AUROC":[325],"0.64,":[326],"p":[327],"<":[328],"0.001).":[329],"Conclusion:":[330],"Conventional":[331],"grossly":[335],"underestimate":[336],"occult":[337],"accumulation":[339],"acute":[343],"injury.":[345],"Integrating":[346],"serial":[347],"POCUS\u2014":[349],"specifically":[350],"ultrasound,":[352],"dynamics,":[356],"grading\u2014provides":[359],"rapid,":[361],"highly":[362],"accurate":[363],"framework":[365],"recognition":[368],"guiding":[372],"targeted":[373],"decongestive":[374],"therapies,":[375],"potentially":[377],"mitigating":[378],"adverse":[379],"outcomes.":[381]},"counts_by_year":[],"updated_date":"2026-11-01T11:40:01.658920","created_date":"2026-10-31T00:00:00"}