In our experience the VExUS score can be used effectively in children with kidney disease. We applied the VExUS to the pediatric population, which is different from adults for which the score was created, but we noted its efficacy in this group of patients to estimate fluid overload. Based on the results of this study, we propose this score to estimate the ideal dialysis weight to prevent intradialytic symptoms (cramps, hypotension) [7,8]. We need further studies with a larger number of patients to confirm our hipothesis. VExUS score finally, is a rapid, safe, non-invasive, and inexpensive ultrasound protocol usueful to evaluate status of venous congestion. In future it could represent an indispensable guide to achieving the best possible therapeutic goal, avoiding over- or under-treatment.