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Renal ultrasound provides low utility in evaluating cardiac surgery associated acute kidney injury

Title: Renal ultrasound provides low utility in evaluating cardiac surgery associated acute kidney injury
Authors: Young, A
Crawford, T
Pierre, AS
Magruder, JT
Fraser, C
Conte, J
Whitman, G
Sciortino, C
Item Type: Journal Article
Abstract: Background Renal ultrasonography is part of the algorithm in assessing acute kidney injury (AKI). The purpose of this study was to assess the clinical utility of renal US in postoperative cardiac patients who develop AKI. Methods We conducted a retrospective study of 90 postoperative cardiac surgery patients at a single institution from 1/19/2010 to 3/19/2016 who underwent renal US for AKI. We reviewed provider documentation to determine whether renal US changed management. We defined change as: administration of crystalloid or colloid, addition of inotropic or vasopressor, or procedural interventions on the renal system. Results Mean age of study patients was 68 ± 13 years. 48/90 patients (53.3%) had pre-existing chronic kidney disease of varying severity. 48 patients (53.3%) had normal renal US with incidental findings and 31 patients (34.4%) had US evidence of medical kidney disease. 10 patients (11.1%) had limited US results due to poor visualization and 1 patient (1.1%) had mild right-sided hydronephrosis. No patients were found to have obstructive uropathy or renal artery stenosis. Clinical management was altered in only 4/90 patients (4.4%), which included 3 patients that received a fluid bolus and 1 patient that received a fluid bolus and inotropes. No vascular or urologic procedures resulted from US findings. Conclusion Although renal ultrasound is often utilized in the work-up of AKI, our study shows that renal US provides little benefit in managing postoperative cardiac patients. This diagnostic modality should be scrutinized rather than viewed as a universal measure in the cardiac surgery population.
Issue Date: 2-Sep-2017
Date of Acceptance: 24-Aug-2017
URI: http://hdl.handle.net/10044/1/51307
DOI: https://dx.doi.org/10.1186/s13019-017-0637-x
ISSN: 1749-8090
Publisher: BioMed Central
Journal / Book Title: Journal of Cardiothoracic Surgery
Volume: 12
Copyright Statement: © The Author(s). 2017
Keywords: Science & Technology
Life Sciences & Biomedicine
Cardiac & Cardiovascular Systems
Cardiovascular System & Cardiology
Cardiac
Kidney
Renal function failure
Dialysis
Ultrasound
Postoperative care
CRITICALLY-ILL PATIENTS
INTENSIVE-CARE UNITS
RISK-FACTORS
ARTERY STENOSIS
FAILURE
STRATIFICATION
MULTICENTER
DYSFUNCTION
SONOGRAPHY
MORTALITY
Cardiac
Dialysis
Kidney
Postoperative care
Renal function failure
Ultrasound
Science & Technology
Life Sciences & Biomedicine
Cardiac & Cardiovascular Systems
Cardiovascular System & Cardiology
Cardiac
Kidney
Renal function failure
Dialysis
Ultrasound
Postoperative care
CRITICALLY-ILL PATIENTS
INTENSIVE-CARE UNITS
RISK-FACTORS
ARTERY STENOSIS
FAILURE
STRATIFICATION
MULTICENTER
DYSFUNCTION
SONOGRAPHY
MORTALITY
1103 Clinical Sciences
Respiratory System
Publication Status: Published
Article Number: 75
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