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

Allen Young, Todd Crawford, Alejandro Suarez Pierre, J. Trent Magruder, Charles Fraser, John Conte, Glenn Whitman, Christopher Sciortino

Research output: Contribution to journalArticle

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.

Original languageEnglish (US)
Article number75
JournalJournal of Cardiothoracic Surgery
Volume12
Issue number1
DOIs
Publication statusPublished - Sep 2 2017

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Keywords

  • Cardiac
  • Dialysis
  • Kidney
  • Postoperative care
  • Renal function failure
  • Ultrasound

ASJC Scopus subject areas

  • Surgery
  • Cardiology and Cardiovascular Medicine

Cite this

Young, A., Crawford, T., Pierre, A. S., Trent Magruder, J., Fraser, C., Conte, J., ... Sciortino, C. (2017). Renal ultrasound provides low utility in evaluating cardiac surgery associated acute kidney injury. Journal of Cardiothoracic Surgery, 12(1), [75]. https://doi.org/10.1186/s13019-017-0637-x