Keywords
Ultrasonography
Hydronephrosis
Case reports
How to Cite
Abstract
Introduction: Point-of-care ultrasound (POCUS) is a quick and easy-to-use tool that allows correlating anamnesis with ultrasound findings. It has gained strength in different fields of medical practice. In nephrology, it has been used for patients with chronic kidney disease, showing anatomical and vascular alterations; even so, there is little literature on its use in renal transplant patients.
Purpose: To expose how POCUS was used in a series of patients of Colombiana de Transplantes and the impact on their clinical outcomes, correlating findings with a review of the current literature.
Presentation of the case: We report 3 cases of renal transplant patients under follow-up by nephrology, in whom POCUS was used for their post-transplant evaluation showing hydronephrosis. Given this finding, radiological confirmation by radiology with ultrasound or pyelography was requested, and timely urinary tract diversion treatment was indicated. The patients presented an adequate clinical and renal function evolution in the follow-up after management.
Discussion and conclusion: The cases presented support the benefit of POCUS in the follow-up of transplant patients, allowing timely identification and management of hydronephrosis. It is considered that this study may be the first step in using this tool in this population's follow-up routine. However, even so, emphasis is placed on the need for studies with a larger sample size that include different ultrasound findings.
References
Rice JA, Brewer J, Speaks T, Choi C, Lahsaei P, Romito BT. The POCUS Consult: How Point of Care Ultrasound Helps Guide Medical Decision Making. Int J Gen Med. 2021;14. https://doi.org/10.2147/IJGM.S339476
Koratala A, Ronco C, Kazory A. Multi-organ point-of-care ultrasound in acute kidney injury. Blood Purif. 2022;51(12):967-71. https://doi.org/10.1159/000522652
Niyyar VD, O’Neill WC. Point-of-care ultrasound in the practice of nephrology. Kidney Int. 2018;93(5):1052-9. https://doi.org/10.1016/j.kint.2017.11.032
Reyna-Sepúlveda F, Ponce-Escobedo A, Guevara-Charles A, Escobedo-Villarreal M, Pérez-Rodríguez E, Muñoz-Maldonado G, et al. Outcomes and Surgical Complications in Kidney Transplantation. Int J Organ Transplant Med. 2017;8(2):78-84.
Ricketts J, Pang CL, Dissanayake P, Hutchinson R, Gutteridge C. Active haemorrhage of a renal allograft detected on portable ultrasound. BMJ Case Rep. 2013. https://doi.org/10.1136/bcr-2013-009614
Chu L, Jacobs BL, Schwen Z, Schneck FX. Hydronephrosis in pediatric kidney transplant: clinical relevance to graft outcome. J Pediatr Urol. 2013 abr.;9(2):217-22. https://doi.org/10.1016/j.jpurol.2012.02.012
Acharya R, Aly R, Upadhyay K. Renal transplant hydroureteronephrosis as a manifestation of rejection: an under-recognized entity? Case Rep Nephrol Dial. 2021;11(1):87-94. https://doi.org/10.1159/000514199
Maier U, Madersbacher S, Banyai-Falger S, Susani M, Grünberger T. Late ureteral obstruction after kidney transplantation. Transpl Int. 1997;10(1):65-8. https://doi.org/10.1007/BF02044345
Hoytfox V, Ward B, Cox E, Zhang K. POCUS evaluation in acute kidney injury. POCUS J. 2021;6(2):67-9. https://doi.org/10.24908/pocus.v6i2.14775
Nixon G, Blattner K, Muirhead J, Kerse N. Rural point-of-care ultrasound of the kidney and bladder: quality and effect on patient management. J Prim Health Care. 2018;10(4):324-30. https://doi.org/10.1071/HC18034
Arnold MJ, Jonas CE, Carter RE. Point-of-Care Ultrasonography. Am Fam Physician. 2020;101(5):275-85.
Smallwood N, Dachsel M. Point-of-care ultrasound (POCUS): unnecessary gadgetry or evidence-based medicine? Clin Med. 2018;18(3):219-24. https://doi.org/10.7861/clinmedicine.18-3-219
Hashim A, Tahir MJ, Ullah I, Asghar MS, Siddiqi H, Yousaf Z. The utility of point of care ultrasonography (POCUS). Ann Med Surg. 2021;71:102982. https://doi.org/10.1016/j.amsu.2021.102982
Carrera KG, Hassen G, Camacho-Leon GP, Rossitto F, Martinez F, Debele TK. The benefits and barriers of using point-of-care ultrasound in primary healthcare in the United States. Cureus. 2022;14(8):e28373. https://doi.org/10.7759/cureus.28373
Ross DW, Moses AA, Niyyar VD. Point-of-care ultrasonography in nephrology comes of age. Clin Kidney J. 2022;15(12):2220-7. https://doi.org/10.1093/ckj/sfac160
Leo M, Langlois BK, Pare JR, Mitchell P, Linden J, Nelson KP, et al. Ultrasound vs. computed tomography for severity of hydronephrosis and its importance in renal colic. West J Emerg Med. 2017;18(4):559-68. https://doi.org/10.5811/westjem.2017.04.33119
Watkins S, Bowra J, Sharma P, Holdgate A, Giles A, Campbell L. Validation of emergency physician ultrasound in diagnosing hydronephrosis in ureteric colic. Emerg Med Australas. 2007;19(3):188-95. https://doi.org/10.1111/j.1742-6723.2007.00925.x
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.