Letter to the Editor: Artificial intelligence in nephrology point-of-care ultrasonography - opportunities, limitations, and future directions.

We read with interest the retrospective cohort study by Silipigni et al entitled "Role of point-of-care ultrasonography in kidney disease management: A single solution for multiple challenges". Artificial intelligence (AI) is rapidly reshaping the way clinicians learn, perform, and interpret point-of-care ultrasonography (POCUS). In nephrology, AI-assisted image acquisition, automated measurements, and emerging decision-support tools offer opportunities to improve efficiency and expand access to POCUS training. At the same time, important limitations remain, particularly when ultrasound findings must be integrated with physiology and clinical context. In this commentary, we discuss the current role of AI in nephrology POCUS, examine potential pitfalls of overreliance on automated interpretation, and consider future applications that may extend beyond image analysis toward physiologic assessment and hemodynamic phenotyping. Ultimately, we suggest that AI should be used to enhance, not replace clinicians' understanding of anatomy, physiology, and patient-specific pathophysiology.