Point of care ultrasonography in onco-nephrology: A stride toward better physical examination

Abstract

Onco-Nephrology is an emerging subspecialty of Nephrology that focuses on a broad spectrum of renal disorders that can arise in patients with cancer. It encompasses acute kidney injury (AKI), complex fluid, electrolyte, and acid-base disorders, as well as chronic kidney disease caused or exacerbated by cancer and/or its treatment. In many such scenarios including AKI and hyponatremia, objective evaluation of hemodynamics is vital for appropriate management. Point of care ultrasonography (POCUS) is a limited ultrasound exam performed at the bedside and interpreted by the treating physician intended to answer focused clinical questions and guide therapy. Compared to conventional physical examination, POCUS offers substantially higher diagnostic accuracy for various structural and hemodynamic derangements. In this narrative review, we provide an overview of the utility of POCUS enhanced physical examination for the Onconephrologist supported by the current evidence and our experience-based opinion.

Keywords: Point of care ultrasonography; Onco-nephrology; Acute kidney injury; Hyponatremia; Volume assessment

Core Tip: Point of care ultrasonography is a valuable adjunct to physical examination in patients with cancer and renal dysfunction or fluid/electrolyte disorders. It provides better diagnostic accuracy than conventional physical examination. Proper training is the key to effectively integrate this diagnostic tool into routine clinical practice.