Nathaniel Reisinger, MD; Abhilash Koratala, MD – We know what you’re thinking. we’ve heard it a thousand times: “Oh, you’re a kidney doctor who dinks around with ultrasound? What do you look for? Hydronephrosis?” You may be asking, “Is this issue just going to be a bunch of pictures of hydronephrosis and distended bladders?” And yes, for the thousandth time, in acute kidney injury it’s almost never wrong to get a kidney and bladder ultrasound as part of the initial workup.
Patrick J. Taus, MD, PhD; Surya Manivannan, MD; Ria Dancel, MD – Given the contrasting echogenic characteristics of the urinary system and their easily identifiable distortion in response to numerous pathologic processes, the sonographic examination of the kidney and bladder can provide a wealth of clinical information. Although performed for decades as a referral and comprehensive radiologic study, improvement in the cost and performance of portable ultrasound devices has now made point of care ultrasound (POCUS) accessible to a growing number and variety of healthcare providers.
David Haughey, MD; Tai Truong, MD – An 87 year old male with obstructive uropathy was initially diagnosed with acute kidney injury (AKI), a new renal mass and hydronephrosis. When transferred to a facility with a hospital medicine POCUS program, the renal mass was correctly identified as a perinephric abscess, which was percutaneously drained leading to resolution of AKI and the underlying infection. Renal POCUS is readily taught via brief educational interventions and empowers providers to identify common (hydronephrosis) and uncommon (perinephric abscess) renal pathology at the bedside.