B-Scan Ultrasound in the Evaluation of Renal Failure

Abstract

Twenty-three patients with blood urea nitrogen (BUN) over 70 and thought clinically to be in renal failure were examined by ultrasound. A correct diagnosis of kidney size and the presence or absence of hydronephrosis or polycystic kidney was made in all but one instance. One kidney in a patient with end-stage renal failure was not seen ultrasonically but was subsequently demonstrated on a retrograde pyelogram. In 10 patients, excretory urography (on 4 occasions with tomography) failed to demonstrate the kidneys adequately. It is suggested that ultrasound should either be the first or second imaging technique in the investigation of patients who present in renal failure of unknown cause.

In Hydronephrosis Less than 10 % Kidney Function is not an Indication for Nephrectomy in Children

“…According to the study of Yarger USG provided only a few false negative results with respect to sensitivity and specificity (14). In one study it was reported that USG could diagnose hydronephrosis in 100 % of the cases (11). In our study all patients were diagnosed by USG because when pelvis and calyces are hugely distended, the cortex and medulla can not be differentiated.…”

The Value of the Intravenous Pyelogram and Micturating Cystourethrogram in the Newborn

“…In 5 infants from this series visualization of the kidneys was not possible on the IVP, ultrasonography (Sanders and Donald, 1976), or percutaneous antegrade pyelography (Fowler and Jensen, 1975), may help in such cases when hydronephrosis or multicystic kidney is suspected.…”

Echotomographic Study in the Diagnosis of the Nonfunctioning Kidney

“…Afterwards two other papers appeared in the literature emphasizing the advantages of nephrosonography in the evaluation of a nonvisualgraphic exploration disclosed bilateral small ized kidney (2,(12)(13)(14)16). kidneys without dilatation of the excretory system, thus ruling out the existence of an obstrue-hydronephrosis.…”

“…When the BUN levels are high, perfusion IVP and tomography can provide useful results, but these results are sometimes poor especially when the patient is obese. In these cases ultrasound examina tion allows to rule out obstructive uropathy and provides specific data about the presence or ab sence of hydronephrosis (13,14) without having to resort to bilateral retrograde catheterism. Evalua tion of the size, renal contour and échographie patterns, may lead to a diagnosis of polycystic disease or contracted kidney in the terminal stage, as we have found in 2 cases studied on an emer gency basis (15,21).…”