Docs Take Charge with Point of Care Kidney Ultrasound

Traditionally, physicians have directed patients to the radiology department for ultrasound examinations of the kidneys/urinary tract to exclude conditions like hydronephrosis. The extended wait times for these examinations often result in delays in administering critical patient treatment. Wouldn't it be more efficient if physicians lacking a radiology background could conduct these examinations themselves?

On a global scale, there is a scarcity of major studies on the utilization of point of care ultrasound for the kidneys/urinary tract, but multiple smaller studies exist. Nevertheless, these studies offer insights into the adeptness with which physicians without a radiology background can swiftly identify pathology, whether in pre-hospital settings, the emergency department, or on the hospital ward.

The study entitled "Intensive care unit physician-delivered point of care renal tract ultrasound in acute kidney injury is feasible" (1) aimed to assess the capability of departmental physicians in performing optimal point of care ultrasound of the urinary system in critically ill patients with acute kidney injury. The authors concluded affirmatively. Another small-scale study (2) appraised the utilization of point of care ultrasound by emergency physicians in comparison to CT/ultrasound conducted by radiologists in patients with acute kidney injury. This study demonstrated a 100% negative predictive value for the absence of hydronephrosis in emergency physicians.

By mastering the application of point of care ultrasound for the kidneys and urinary system, you possess the opportunity to confirm or negate conditions like hydronephrosis. This not only aids in diminishing waiting times but, more crucially, mitigates delays in patient treatment.

References

1. Parulekar P, Neil-Gallacher E, Harrison A. Intensive care unit physician-delivered point of care renal tract ultrasound in acute kidney injury is feasible. J Intensive Care Soc. 2018;19(4):313-8.
2. Nepal S, Dachsel M, Smallwood N. Point-of-care ultrasound rapidly and reliably diagnoses renal tract obstruction in patients admitted with acute kidney injury. Clin Med (Lond). 2020;20(6):541-4.