title: ACR Appropriateness Criteria(®) on renal failure.
abstract: Imaging plays a role in the management of patients with acute kidney injury or chronic kidney disease. However, clinical circumstances strongly impact the appropriateness of imaging use. In patients with newly detected renal dysfunction, ultrasonography can assess for reversible causes, assess renal size and echogenicity, and thus, establish the chronicity of disease. Urinary obstruction can be detected, but imaging is most useful in high-risk groups or in patients in whom there is a strong clinical suspicion for obstruction. Computed tomography, computed tomography or magnetic resonance arteriography, and percutaneous ultrasound-guided renal biopsy are valuable in other clinical situations. The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed every 3 years by a multidisciplinary expert panel. The guideline development and review include an extensive analysis of current medical literature from peer-reviewed journals and the application of a well-established consensus methodology (modified Delphi) to rate the appropriateness of imaging and treatment procedures by the panel. In those instances where evidence is lacking or not definitive, expert opinion may be used to recommend imaging or treatment.
authors.affiliation: Cleveland Clinic, Cleveland, Ohio. Electronic address: remere1@ccf.org.
authors.forename: Erick M
authors.initials: EM
authors.lastname: Remer
authors.affiliation: Hospital of University of Pennsylvania, Philadelphia.
authors.forename: Nicholas
authors.initials: N
authors.lastname: Papanicolaou
authors.affiliation: Northwestern University, Chicago, Ill.
authors.forename: David D
authors.initials: DD
authors.lastname: Casalino
authors.affiliation: Intermountain Urological Institute, Murray, Utah.
authors.forename: Jay T
authors.initials: JT
authors.lastname: Bishoff
authors.affiliation: Albert Einstein College of Medicine, Bronx, NY.
authors.forename: M Donald
authors.initials: MD
authors.lastname: Blaufox
authors.affiliation: Emory University Hospital, Atlanta, Ga.
authors.forename: Courtney A
authors.initials: CA
authors.lastname: Coursey
authors.affiliation: University of Washington Medical Center, Seattle.
authors.forename: Manjiri
authors.initials: M
authors.lastname: Dighe
authors.affiliation: University of New Mexico, Albuquerque.
authors.forename: Steven C
authors.initials: SC
authors.lastname: Eberhardt
authors.affiliation: University of Pennsylvania School of Medicine, Philadelphia.
authors.forename: Stanley
authors.initials: S
authors.lastname: Goldfarb
authors.affiliation: Scottsdale Medical Imaging, Ariz.
authors.forename: Howard J
authors.initials: HJ
authors.lastname: Harvin
authors.affiliation: University of Utah, Salt Lake City.
authors.forename: Marta E
authors.initials: ME
authors.lastname: Heilbrun
authors.affiliation: Wake Forest University School of Medicine, Winston Salem, NC.
authors.forename: John R
authors.initials: JR
authors.lastname: Leyendecker
authors.affiliation: Northwestern University, Chicago, Ill.
authors.forename: Paul
authors.initials: P
authors.lastname: Nikolaidis
authors.affiliation: The University of Chicago, Ill.
authors.forename: Aytekin
authors.initials: A
authors.lastname: Oto
authors.affiliation: Duke University Medical Center, Durham, NC.
authors.forename: Glenn M
authors.initials: GM
authors.lastname: Preminger
authors.affiliation: University of California Los Angeles Medical Center.
authors.forename: Steven S
authors.initials: SS
authors.lastname: Raman
authors.affiliation: Johns Hopkins Hospital, Baltimore, Md.
authors.forename: Sheila
authors.initials: S
authors.lastname: Sheth
authors.affiliation: University of Texas MD Anderson Cancer Center, Houston.
authors.forename: Raghunandan
authors.initials: R
authors.lastname: Vikram
authors.affiliation: Oakland University William Beaumont School of Medicine, Troy, Mich.
authors.forename: Robert M
authors.initials: RM
authors.lastname: Weinfeld
mesh_terms: D058186:Acute Kidney Injury / Q000145:classification / Q000175:diagnosis* / Q000209:etiology; D044963:Biopsy, Fine-Needle; D003287:Contrast Media; D003952:Diagnostic Imaging / Q000592:standards*; D006801:Humans; D007668:Kidney / Q000473:pathology; D017410:Practice Guidelines as Topic; D051436:Renal Insufficiency, Chronic / Q000175:diagnosis* / Q000209:etiology; D012955:Societies, Medical; D014481:United States
chemical_list: D003287:Contrast Media
keywords: Acute kidney injury; Appropriateness criteria; Chronic kidney disease; Ultrasound