{"doi":"10.1002/jum.15897","title":"Ultrasound Pressure Estimation for Diagnosing Portal Hypertension in Patients Undergoing Dialysis for Chronic Kidney Disease","abstract":"OBJECTIVES: Hepatic venous pressure gradient (HVPG) is considered the standard in quantifying portal hypertension, but can be unreliable in dialysis patients. A noninvasive ultrasound technique, subharmonic-aided pressure estimation (SHAPE), may be a valuable surrogate of these pressure estimates. This study compared SHAPE and HVPG with pathology findings for fibrosis in dialysis patients. METHODS: This was a subgroup study from an IRB-approved trial that included 20 patients on dialysis undergoing SHAPE examinations of portal and hepatic veins using a modified Logiq 9 scanner (GE, Waukesha, WI), during infusion of Sonazoid (GE Healthcare, Oslo, Norway). SHAPE was compared to HVPG and pathology findings using the Ludwig-Batts scoring system for fibrosis. Logistic regression, ROC analysis, and t-tests were used to compare HVPG and SHAPE with pathological findings of fibrosis. RESULTS: Of 20 cases, 5 had HVPG values corresponding to subclinical and clinical portal hypertension (≥6 and ≥10 mmHg, respectively) while 15 had normal HVPG values (≤5 mmHg). SHAPE and HVPG correlated moderately (r = 0.45; P = .047). SHAPE showed a trend toward correlating with fibrosis (r = 0.42; P = .068), while HVPG did not (r = 0.18; P = .45). SHAPE could differentiate between mild (stage 0-1) and moderate to severe (stage 2-4) fibrosis (-10.4 ± 4.9 dB versus -5.4 ± 3.2 dB; P = .035), HVPG could not (3.0 ± 0.6 mmHg versus 4.8 ± 0.7 mmHg; P = .30). ROC curves showed a diagnostic accuracy for SHAPE of 80%, while HVPG reached 76%. CONCLUSION: Liver fibrosis staging in dialysis patients evaluated for portal hypertension appears to be more accurately predicted by SHAPE than by HVPG; albeit in a small sample size.","journal":"Journal of Ultrasound in Medicine","year":2021,"id":192495,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":12,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9649,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2021-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":300929,"name":"Ipshita Gupta","orcid":"0000-0002-4336-1960","position":1,"is_corresponding":false},{"id":300932,"name":"Jonathan M. Fenkel","orcid":"0000-0003-4612-8416","position":2,"is_corresponding":false},{"id":297776,"name":"Sriharsha Gummadi","orcid":"0000-0001-8597-6114","position":3,"is_corresponding":false},{"id":300931,"name":"Maria Stanczak","orcid":"0000-0003-0783-1723","position":4,"is_corresponding":false},{"id":297773,"name":"Corinne E. Wessner","orcid":"0000-0002-5896-3841","position":5,"is_corresponding":false},{"id":297788,"name":"Colette M. Shaw","orcid":"0000-0002-0879-4445","position":6,"is_corresponding":false},{"id":300934,"name":"Susan M. Schultz","orcid":"0000-0001-8635-6021","position":7,"is_corresponding":false},{"id":259899,"name":"Michael C. Soulen","orcid":"0000-0001-8136-2123","position":8,"is_corresponding":false},{"id":300936,"name":"Kirk Wallace","orcid":"0000-0003-3923-5045","position":9,"is_corresponding":false},{"id":297771,"name":"John R. Eisenbrey","orcid":"0000-0001-6411-3424","position":10,"is_corresponding":false},{"id":297772,"name":"Flemming Forsberg","orcid":"0000-0003-2215-1371","position":11,"is_corresponding":false},{"id":300930,"name":"Priscilla Machado","orcid":"0000-0003-4107-2986","position":0,"is_corresponding":true}],"reference_count":51,"raw_metadata":null,"created_at":"2026-07-18T23:49:43.496702Z","pmid":"34850412","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}