Renal ultrasound

Ultrasound is a valuable tool in renal medicine.

Renal ultrasound may be used to measure:

• kidney size
• dilatation of the renal pelvis or ureters
• residual volumes of urine the post micturition bladder
• renal calculi in the renal pelvis or bladder
• cysts or masses in the renal parenchyma
• the prostate - using a rectal probe

The limitations of ultrasound in renal medicine must be remembered:

• it is operator dependant
• it cannot visualise the full length of the ureter
• the resolution is not sufficient to demonstrate pelvicalyceal abnormalities such as papillary necrosis

Indications for renal ultrasound in CKD (1)

Offer a renal ultrasound scan to all people with CKD who:

• have accelerated progression of CKD
• have visible or persistent invisible haematuria
• have symptoms of urinary tract obstruction
• have a family history of polycystic kidney disease and are aged over 20 years
• have a GFR of less than 30 ml/min/1.73 m2 (GFR category G4 or G5)
• are considered by a nephrologist to require a renal biopsy

Advise people with a family history of inherited kidney disease about the implications of an abnormal result before a renal ultrasound scan is arranged for them

Reference:

• NICE (July 2014). Chronic kidney disease early identification and management of chronic kidney disease in adults in primary and secondary care