PDF(Pubmed)
Abstract：
UNASSIGNED: Acute kidney injury (AKI) is common among hospitalised patients and can lead to significant morbidity or mortality if not properly managed. Renal ultrasound (RUS) is often requested in the initial workup of AKI to rule out obstructive uropathy despite pre-renal aetiologies being implicated in most cases, especially in patients without risk factors for obstruction.
UNASSIGNED: Determine the utility of RUS in detecting bilateral hydronephrosis in the context of AKI, and identify risk factors that can be used to stratify patients to better guide patient management.
UNASSIGNED: Adults who underwent RUS for AKI between January 2019 and December 2021 were reviewed. Renal ultrasound studies that identified bilateral hydronephrosis and the patient characteristics associated with these studies were recorded.
UNASSIGNED: Seven hundred and fifty-eight RUS reports were included. Bilateral hydronephrosis was diagnosed in 43 patients (5.7%). Of these 43 patients, 39 (90.7%) had at least one risk factor for urinary tract obstruction. Bilateral hydronephrosis was only diagnosed in 4 (9.3%) patients without any risk factor for obstruction. The risk factors with the highest odds for being diagnosed with bilateral hydronephrosis included a history of previous ureteric stenting or nephrostomy tube insertion (OR 10.37), previous bilateral hydronephrosis (OR 14.56), or multiple risk factors (OR 23.06).
UNASSIGNED: Renal ultrasound has limited utility in the evaluation of AKI in low-risk patients.
UNASSIGNED: These risk factors can be used to assign patients to high- or low-risk categories to better guide management and reduce the number of unnecessary studies performed while still identifying clinically significant disease.
UNASSIGNED: Determine the utility of RUS in detecting bilateral hydronephrosis in the context of AKI, and identify risk factors that can be used to stratify patients to better guide patient management.
UNASSIGNED: Adults who underwent RUS for AKI between January 2019 and December 2021 were reviewed. Renal ultrasound studies that identified bilateral hydronephrosis and the patient characteristics associated with these studies were recorded.
UNASSIGNED: Seven hundred and fifty-eight RUS reports were included. Bilateral hydronephrosis was diagnosed in 43 patients (5.7%). Of these 43 patients, 39 (90.7%) had at least one risk factor for urinary tract obstruction. Bilateral hydronephrosis was only diagnosed in 4 (9.3%) patients without any risk factor for obstruction. The risk factors with the highest odds for being diagnosed with bilateral hydronephrosis included a history of previous ureteric stenting or nephrostomy tube insertion (OR 10.37), previous bilateral hydronephrosis (OR 14.56), or multiple risk factors (OR 23.06).
UNASSIGNED: Renal ultrasound has limited utility in the evaluation of AKI in low-risk patients.
UNASSIGNED: These risk factors can be used to assign patients to high- or low-risk categories to better guide management and reduce the number of unnecessary studies performed while still identifying clinically significant disease.
摘要：
急性肾损伤（AKI）在住院患者中很常见，如果管理不当，可能导致显著的发病率或死亡率。尽管在大多数情况下涉及肾前病因，但在AKI的初始检查中通常需要肾超声（RUS）以排除阻塞性尿路病。尤其是没有梗阻危险因素的患者。
■确定RUS在AKI背景下检测双侧肾积水的效用，并确定可用于对患者进行分层的风险因素，以更好地指导患者管理。
■对2019年1月至2021年12月期间因AKI接受RUS治疗的成年人进行了审查。记录确定双侧肾积水的肾脏超声研究以及与这些研究相关的患者特征。
■包括758份RUS报告。43例患者诊断为双侧肾积水（5.7％）。在这43名患者中，39例（90.7%）至少有一个尿路梗阻的危险因素。仅在4例（9.3％）没有任何阻塞危险因素的患者中诊断出双侧肾积水。被诊断为双侧肾积水的几率最高的危险因素包括既往输尿管支架置入或肾造瘘管的病史（OR10.37），既往双侧肾积水（OR14.56），或多个危险因素（OR23.06）。
■肾脏超声在低风险患者AKI评估中的应用有限。
■这些风险因素可用于将患者分为高风险或低风险类别，以更好地指导管理并减少进行不必要研究的数量，同时仍可识别出临床上有意义的疾病。
■确定RUS在AKI背景下检测双侧肾积水的效用，并确定可用于对患者进行分层的风险因素，以更好地指导患者管理。
■对2019年1月至2021年12月期间因AKI接受RUS治疗的成年人进行了审查。记录确定双侧肾积水的肾脏超声研究以及与这些研究相关的患者特征。
■包括758份RUS报告。43例患者诊断为双侧肾积水（5.7％）。在这43名患者中，39例（90.7%）至少有一个尿路梗阻的危险因素。仅在4例（9.3％）没有任何阻塞危险因素的患者中诊断出双侧肾积水。被诊断为双侧肾积水的几率最高的危险因素包括既往输尿管支架置入或肾造瘘管的病史（OR10.37），既往双侧肾积水（OR14.56），或多个危险因素（OR23.06）。
■肾脏超声在低风险患者AKI评估中的应用有限。
■这些风险因素可用于将患者分为高风险或低风险类别，以更好地指导管理并减少进行不必要研究的数量，同时仍可识别出临床上有意义的疾病。
