Post renal failure (obstructive failure) can account for up to 15% of acute renal failure. POCUS can be used in the acute setting to determine if obstruction is contributing to an acute episode of renal failure. In this video the causes of unilateral and bilateral obstruction, including the degrees of hydronephrosis, will be reviewed.
Implementation of POCUS can lead to early discovery of obstructive uropathy in the patient with acute renal failure and can guide appropriate therapy.
Check out these other videos on Renal Ultrasound:
Basic Renal Ultrasound - • POCUS - Basic Renal U...
UVJ stone with hydronephrosis - • Ureterolithiasis at th...
Urinary retention with severe hydronephrosis - • Urinary Retention with...
References:
- Podoll, A., Walther, C. & Finkel, K. Clinical utility of gray scale renal ultrasound in acute kidney injury. BMC Nephrol 14, 188 (2013). doi.org/10.1186/1471-2369-14-188
- Faubel S, Patel NU, Lockhart ME, Cadnapaphornchai MA. Renal relevant radiology: use of ultrasonography in patients with AKI. Clin J Am Soc Nephrol. 2014 Feb;9(2):382-94. doi: 10.2215/CJN.04840513. Epub 2013 Nov 14. PMID: 24235286; PMCID: PMC3913238.
- Gamss R, Stein MW, Rispoli JM, Cohen HW, Roberts JH, Koenigsberg M, Mazzariol FS. What Is the Appropriate Use of Renal Sonography in an Inner-City Population With New-Onset Acute Kidney Injury? J Ultrasound Med. 2015 Sep;34(9):1639-44. doi: 10.7863/ultra.15.14.04026. Epub 2015 Aug 17. PMID: 26283754; PMCID: PMC5310182.
Can you please do appendix POCUS video for adults and Peds? Thank you! I really appreciate all your lectures
Thanks sir
Hi, nice video. You said in mild and moderate hydronephrosis you send patients home. What do you do with the stones that caused them?
If the patient's pain is controlled and their kidney function is unchanged then they can be discharged from the emergency department or clinic and can follow up with urology in the near future. Many of these stones will pass spontaneously and not need intervention. If the stone does not pass then the urologist can take care of this in follow up. They should, however, receive instructions of symptoms the indicate worsening/complications such as - continuous vomiting, fevers, dysuria, intolerable pain, etc. If any of these develop the patient should return for more immediate care.