Transcending boundaries: Unleashing the potential of multi-organ point-of-care ultrasound in acute kidney injury

Abstract

Acute kidney injury (AKI) is a clinical syndrome characterized by a rapid increase in serum creatinine levels or a decrease in urine output or both. In spite of thorough history-taking, physical examination, and laboratory analysis, there are limitations in the diagnostic process and clinical monitoring of AKI. Point-of-care ultrasonography (POCUS), a limited ultrasound study performed by clinicians at the bedside, has emerged as a valuable tool in different clinical settings. In this discussion, we explore the potential of POCUS performed by nephrologists to address specific questions encountered in the diagnosis and management of AKI patients. POCUS not only aids in excluding hydronephrosis but also provides real-time insights into hemodynamics, enabling formulation of individualized treatment plans. Further studies are required to assess the impact of multi-organ POCUS on pragmatic patient outcomes related to AKI, as well as its potential in risk stratification and identification of different levels of AKI severity and pathophysiological signatures.

Keywords: Ultrasound; Point-of-care ultrasonography; Doppler; Venous excess Doppler ultrasound; Congestion; Hemodynamics; Heart failure; Nephrology

Core Tip: Point-of-care ultrasound, not limited to kidney is a valuable addition to nephrologists’ toolkit, which enhances diagnostic accuracy and guides therapy when properly integrated with clinical and laboratory parameters.