The Renal Ultrasound in Patients with Acute Kidney Injury
Mahvesh K. Mahmud *
Department of Medicine, Ziauddin University Hospital, Clifton Campus 4/B, Sharah-e-Ghalib, Block 6, Clifton Karachi, Pakistan
Waseem Mehmood Nizamani
Department of Radiology, Ziauddin University Hospital, Clifton Campus 4/B, Sharah-e-Ghalib, Block 6, Clifton Karachi, Pakistan
Nida Hussain
Department of Medicine, Ziauddin University Hospital, Clifton Campus 4/B, Sharah-e-Ghalib, Block 6, Clifton Karachi, Pakistan
Zarak Iqbal Samoo
Ziauddin University Hospital, Clifton Campus 4/B, Sharah-e-Ghalib, Block 6, Clifton Karachi, Pakistan.
Wahaaj Ali Khan
Ziauddin University Hospital, Clifton Campus 4/B, Sharah-e-Ghalib, Block 6, Clifton Karachi, Pakistan.
Farah Ahmad
Department of Community Health Sciences, Ziauddin University Hospital, Clifton Campus 4/B, Sharah-e-Ghalib, Block 6, Clifton Karachi, Pakistan.
Syed Hasan Danish
Department of Community Health Sciences, Ziauddin University Hospital, Clifton Campus 4/B, Sharah-e-Ghalib, Block 6, Clifton Karachi, Pakistan
*Author to whom correspondence should be addressed.
Abstract
Aims: Acute Kidney Injury (AKI) is seen in 15% of hospitalized patients and a renal ultrasound (RUS) is often ordered to exclude an obstructive cause in the initial evaluation of AKI. This study was done to evaluate the usefulness of a RUS in patients with AKI in a developing country.
Methods: This was a retrospective study on all patients who were referred to nephrology with AKI and had a RUS, over a one-year period at a tertiary care teaching hospital of Karachi, Pakistan. The patients’ charts were reviewed for clinical characteristics and the RUS findings were documented.
Results: A significant number of patients did not have documented risk factors for obstruction based on the medical history. Hydronephrosis was found in 22.5% (25 out of 111) of patients, and in 14 of these cases, the etiology of the acute kidney injury was found to be obstructive uropathy. The presence of nephrolithiasis and/or benign prostatic hypertrophy was associated with and increased likelihood of finding hydronephrosis on RUS.
Conclusions: We thus recommend doing a renal ultrasound in all cases of AKI due to the fact that most of the time in a developing country, an accurate history is not available, and the prevalence of stone disease and obstructive uropathy is high.
Keywords: Acute kidney injury, hydronephrosis, obstructive uropathy, renal ultrasound.