Point of care renal ultrasonography for the busy nephrologist: A pictorial review

Abstract

The application of bedside ultrasonography in routine clinical practice has dramatically evolved over the last few decades and will likely continue to grow as technological advances lead to enhanced portability and affordability of the equipment. Despite mounting interest, most nephrology fellowship training programs do not offer formal training in renal ultrasonography and there is inertia among practicing nephrologists to adopt this skill as a practice-changing advancement. Lack of familiarity with the topic is considered a key reason for this inertia. Understanding of basic ultrasound physics, instrumentation, principles of optimal image acquisition and interpretation is critical for enhanced efficiency and patient safety while using this tool. Herein, we provide a brief overview of the basic principles of diagnostic renal ultrasonography as well as introduction to common sonographic pathologies encountered in day-to-day nephrology practice with illustrative images.

Point-of-Care Ultrasound Training: An Assessment of Interns’ Needs and Barriers to Training

“…Point of care ultrasound (POCUS) is a fast, portable, and non-invasive diagnostic tool [1][2][3]. Physicians proficient in its use can quickly answer specific clinical questions at the bedside.…”

“…Physicians proficient in its use can quickly answer specific clinical questions at the bedside. The diagnostic accuracy of POCUS for detection of many pathologies (e.g., pleural effusion, pneumothorax, pneumonia, and interstitial syndromes [4][5][6][7][8][9], hydronephrosis [1,2], hepatomegaly [10], splenomegaly [11], and ascites [10]) is excellent. Therefore, POCUS is an invaluable adjunct to bedside diagnostic evaluation.…”

“…There is substantial evidence to support the clinical value of POCUS to several specialties [1][2][3]12]. Yet, surprisingly, practicing physicians have been mostly reluctant to integrate this paradigm-shifting technology into their routine practice [1]. This is partly due to their lack of familiarity with the tool [1].…”

“…Yet, surprisingly, practicing physicians have been mostly reluctant to integrate this paradigm-shifting technology into their routine practice [1]. This is partly due to their lack of familiarity with the tool [1]. As POCUS is a relatively new technology, most frontline physicians have little or no experience with its use.…”

A correlation study of the effectiveness of renal scintigraphy and sonography in the detection and evaluation of renal disorders

“…Voiding cystourethrography (VCUG) is recommended if ultrasonography diagnoses scarring, hydronephrosis or other ndings suggestive of obstructive uropathy or vesicoureteral re ux [19]. Renal scintigraphy scan is a preferred diagnostic test to estimate GFR and blood ow in kidneys [20]. In most of the cases, renal US are effective to identify urinary tract abnormalities but not prioritized for renal parenchymal diagnosis [21].…”