Renal relevant radiology: use of ultrasonography in patients with AKI.
As judged by the American College of Radiology Appropriateness Criteria, renal Doppler ultrasonography is the most appropriate imaging test in the evaluation of AKI and has the highest level of recommendation. Unfortunately, nephrologists are rarely specifically trained in ultrasonography technique and interpretation, and important clinical information obtained from renal ultrasonography may not be appreciated. In this review, the strengths and limitations of grayscale ultrasonography in the evaluation of patients with AKI will be discussed with attention to its use for (1) assessment of intrinsic causes of AKI, (2) distinguishing acute from chronic kidney diseases, and (3) detection of obstruction. The use of Doppler imaging and the resistive index in patients with AKI will be reviewed with attention to its use for (1) predicting the development of AKI, (2) predicting the prognosis of AKI, and (3) distinguishing prerenal azotemia from intrinsic AKI. Finally, pediatric considerations in the use of ultrasonography in AKI will be reviewed.
Division of Internal Medicine, Nephrology, University of Colorado and Denver Veterans Affairs Medical Center, Denver, Colorado;, †Department of Radiology and, §Department of Internal Medicine and Pediatrics, Nephrology, University of Colorado Denver, Denver, Colorado, ‡Department of Radiology, University of Alabama at Birmingham, Birmingham, Alabama.
Sarah
S
Faubel
Nayana U
NU
Patel
Mark E
ME
Lockhart
Melissa A
MA
Cadnapaphornchai
D058186:Acute Kidney Injury / Q000000981:diagnostic imaging* / Q000209:etiology; D000293:Adolescent; D000328:Adult; D000367:Age Factors; D002648:Child; D002675:Child, Preschool; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007668:Kidney / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011379:Prognosis; D012307:Risk Factors; D012720:Severity of Illness Index; D014057:Tomography, X-Ray Computed; D018608:Ultrasonography, Doppler; D055815:Young Adult