Point-of-care ultrasound rapidly and reliably diagnoses renal tract obstruction in patients admitted with acute kidney injury

Abstract

Point-of-care ultrasound (POCUS) is increasingly being used in the management of the acutely unwell patient. Its role in the breathless and shocked patient is well established, but less so for those patients with acute kidney injury (AKI). This local quality improvement project looked at the diagnostic accuracy of a protocolised POCUS versus departmental ultrasound. It provides the first data within the internal medicine setting to suggest that POCUS can rapidly and reliably diagnose renal tract obstruction, showing a sensitivity of 90% and a specificity of 100%. Additionally, negative predictive value was 99% suggesting it is a tool which can reduce the need for departmental ultrasound. More work is needed to see if this data is generalisable to other internal medicine settings, and to assess potential outcomes on patient management and length of stay.