The Use of Point-of-Care Ultrasound in Acute Kidney Injuries

Abstract

Acute kidney injuries (AKI) are a common problem encountered by internists in the inpatient and outpatient setting. Uncovering the etiology becomes important in tailoring treatment. Point-of-care ultrasound (POCUS), when used in conjunction with a patient’s history and physical exam, can quickly identify if hydronephrosis is present and shed light on the underlying etiology. In this article, we discuss how incorporating POCUS into the initial assessment of patients with an AKI can reduce the number of unnecessary and expensive formal renal ultrasounds and potentially expedite clinically appropriate treatment. The purpose of this review is to examine the benefits, reliability, and feasibility of POCUS to further evaluate and manage patients with AKI. An extensive review of the literature was performed and found POCUS to be a reliable and realistic method for internists to incorporate into their assessment of patients with AKI. In this article, we also provide instruction on how to perform a POCUS exam of the kidneys and how to identify hydronephrosis. Furthermore, we discuss the challenges we face and ideas for further practice including the emergence of hand-held ultrasounds.