Point‐of‐care renal ultrasound: Interpret with care

Koratala, Abhilash; Bhattacharya, Deepti; Chamarthi, Gajapathiraju

doi:10.1002/ccr3.1934

Cited by 4 publications

(8 citation statements)

References 3 publications

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“…The ultrasound appearance of the renal vasculature sometimes resembles that of hydronephrosis consistent with a prior report 20 . Our analysis supports that renal POCUS training should emphasize the means by which these conditions can be differentiated, such as by using color Doppler sonography 20–22 …”

Section: Discussionsupporting

confidence: 88%

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Point‐of‐care renal ultrasound: Are longitudinal views of the kidney alone sufficient to rule out hydronephrosis?

et al. 2022

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Objective Point‐of‐care ultrasound for the detection of hydronephrosis is frequently used by emergency physicians. The aim of this study was to assess the accuracy of longitudinal views of the kidney compared with a combination of longitudinal and transverse views of the kidney on emergency physician–performed renal point‐of‐care ultrasound to detect hydronephrosis. Methods This was a retrospective case‐control study of patients who received a renal point‐of‐care ultrasound examination performed and interpreted as hydronephrosis in the emergency department (ED). These were then matched with a cohort of kidneys from different patients without hydronephrosis. Longitudinal ultrasound views and transverse ultrasound views were reviewed for the presence of hydronephrosis by ultrasound‐trained emergency physicians. The gold standard of hydronephrosis was an overall interpretation based on the complete ultrasound examination consisting of both transverse and longitudinal views by ultrasound‐trained emergency physicians. Results Renal point‐of‐care ultrasound exams from 140 kidneys performed in the ED were enrolled in the study. The sensitivity and specificity of longitudinal ultrasound views compared with a combination of longitudinal and transverse ultrasound views of the kidney as a gold standard were 84.3% (95% confidence interval [CI], 77.2–89.9) and 92.9% (95% CI, 87.3–96.5), the positive predictive value was 92.2% (95% CI, 86.1–96.2), and the negative predictive value was 85.5% (95% CI, 78.9–90.7). The positive and negative likelihood ratios were 11.8 (95% CI, 6.5–21.5) and 0.2 (95% CI, 0.1–0.2), respectively. Conclusions Longitudinal views of the kidney on ultrasound showed good sensitivity and specificity to detect the presence of hydronephrosis compared with a combination of longitudinal and transverse ultrasound views of the kidney. However, a combination of longitudinal and transverse ultrasound views may still be warranted in high‐risk patients or in those with inadequate visualization of the upper pole of the kidney.

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Section: Discussionsupporting

confidence: 88%

“… 20 Our analysis supports that renal POCUS training should emphasize the means by which these conditions can be differentiated, such as by using color Doppler sonography. 20 , 21 , 22 …”

Section: Discussionmentioning

confidence: 99%

Point‐of‐care renal ultrasound: Are longitudinal views of the kidney alone sufficient to rule out hydronephrosis?

et al. 2022

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“…There are certain conditions that can mimic hydronephrosis, which physicians performing POCUS need to be aware of. Renal vessels or vascular malformations are common amongst those and can be easily differentiated using color Doppler imaging (Figure 11)[28]. Parapelvic cysts can also mimic hydronephrosis on a renal sonogram because of their hypoechoic nature and close proximity to the collecting system.…”

Section: Common Sonographic Abnormalitiesmentioning

confidence: 99%

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

Koratala¹,

Bhattacharya²,

Kazory³

2019

WJN

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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.

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“…Abnormalities such as large arteriovenous malformations and post-biopsy arteriovenous fistula may be readily detectable on POCUS using color Doppler [ 22 , 23 ]. On the other hand, diagnosis of renal artery stenosis and renal vein thrombosis involves expertise in using spectral Doppler and is generally considered beyond the scope of POCUS.…”

Section: Clinical Usesmentioning

confidence: 99%

“…On the other hand, diagnosis of renal artery stenosis and renal vein thrombosis involves expertise in using spectral Doppler and is generally considered beyond the scope of POCUS. However, clues such as differences in the size of the kidneys in severe renovascular hypertension or absence of flow with visible echogenicity in the main renal vein may still be picked up on bedside evaluation [ 22 , 23 ].…”

Section: Clinical Usesmentioning

confidence: 99%

Point-of-care ultrasound in pediatric nephrology

et al. 2022

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Point-of-care ultrasound (POCUS) has evolved in recent years in clinical practice, helping in early bedside diagnosis of important etiologies. Many medical schools and training programs are integrating POCUS into their curriculum. Especially with the technological advances of newer handheld ultrasound devices, POCUS has now become a component adjunct to clinical examination, in the clinic and bedside in critical care units. The diagnostic utility of POCUS lies both in early identification of critical kidney disease, and also extra-renal pathologies from a focused cardiac ultrasound, lung ultrasound, and integrated fluid assessment. There is a need to incorporate POCUS in training in pediatric nephrology and establish competency standard criteria. This review shall cover how POCUS helps in enhancing patient care in pediatric kidney disorders and critical children, and the recent advances.

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Point‐of‐care renal ultrasound: Interpret with care

Cited by 4 publications

References 3 publications

Point‐of‐care renal ultrasound: Are longitudinal views of the kidney alone sufficient to rule out hydronephrosis?

Point‐of‐care renal ultrasound: Are longitudinal views of the kidney alone sufficient to rule out hydronephrosis?

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

Point-of-care ultrasound in pediatric nephrology

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