Evaluating Point-of-Care Ultrasonography for Acute Kidney Injury
Acute kidney injury (AKI) is a prevalent and severe condition linked to significant morbidity and mortality, with 5–10% of hospitalized patients affected. Post-renal AKI, caused by urinary flow obstruction, accounts for 5–10% of cases and is reversible if diagnosed early. Diagnosis requires imaging, with ultrasonography being the preferred method for detecting hydronephrosis, the key sign of post-renal AKI. Point-of-care ultrasonography (PoCUS), performed at the bedside by treating physicians, offers advantages in terms of speed, portability, and availability compared to radiology-performed imaging. Despite its potential, PoCUS for AKI evaluation has limited uptake due to a lack of detailed test characteristic data.
Improving PoCUS Utilization in AKI Diagnosis
A retrospective cohort study at the Ottawa Hospital reviewed 7873 AKI patients, identifying 4611 eligible cases. Of these, only 94 (2%) underwent PoCUS, and 65 patients underwent both PoCUS and radiology reference imaging. The analysis of 124 kidneys revealed a hydronephrosis prevalence of 33%. PoCUS demonstrated a sensitivity of 85% and specificity of 78% for detecting hydronephrosis, supporting its diagnostic value. Read More
This study highlights the underutilization of PoCUS for AKI, identifying opportunities for quality improvement initiatives to promote its use. The findings underscore the need for standardized training and credentialing for PoCUS providers to enhance diagnostic accuracy and integrate PoCUS as a routine part of AKI management. Further research could expand on these findings to refine diagnostic protocols and improve patient outcomes through more widespread adoption of PoCUS.
