Ultrasound in Diffuse Renal Disease

Abstract

Ultrasound is an essential initial investigation in a patient presenting with renal failure. It gives immediate information on the presence, size and appearance of both kidneys and importantly assesses dilatation of the pelvicalyceal system, which may be due to obstruction. It is the renal ultrasound, which distinguishes patients with obstructive renal failure allowing appropriate treatment and intervention. However, is ultrasound of any further use in the assessment of patients with pre renal, and intrinsic renal failure? Can ultrasound identify patients with intrinsic renal disease, and distinguish different diseases? Moreover can ultrasound identify end stage kidneys and give prognostic information? This article will assess the role of ultrasound in answering these questions by considering ultrasound assessment of renal size, parenchymal thickness and echogenicity. Some specific ultrasound appearances and the role of colour and power doppler in patients with diffuse renal disease will also be considered. Ultrasound can give further information in many circumstances although a renal biopsy is often necessary to make an accurate diagnosis.