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Chronic kidney disease (CKD), also known as chronic renal failure, describes abnormal kidney structure or function, typically represented by a progressive loss of glomerular function. It is present when the glomerular filtration rate (GFR) is less than 60 mL/min/1.73 m 2 for three consecutive months or greater than or equal to this value in ...
On ultrasound, the kidneys may be normal or enlarged, depending on the severity of the condition; the echogenicity of the cortex may be normal or increased and the finding of a markedly echogenic parenchyma in a patient with ARF (Fig. 3.5) should raise the possibility of acute interstitial nephritis. 7
The kidney is surrounded by a capsule separating the kidney from the echogenic perirenal fat, which is seen as a thin linear structure . The kidney is divided into parenchyma and renal sinus. The renal sinus is hyperechoic and is composed of calyces, the renal pelvis, fat and the major intrarenal vessels.
As kidney disease advances, ultrasound is useful in the placement and maintenance of temporary and permanent access for dialysis. After kidney transplantation, ultrasonography is critical for evaluation of allograft dysfunction and for biopsies.
Even when medulla is not visualized, cortical thinning is apparent as a decrease in the thickness of the entire parenchyma, with only a thin rim around the sinus fat. Cortical thinning is often manifested as accentuated lobulation because of atrophy of Bertin's columns between the medullary pyramids . Of the manifestations of cortical atrophy ...
End-stage chronic kidney disease with increased echogenicity, homogenous architecture without visible differentiation between parenchyma and renal sinus and reduced kidney size. Measurement of kidney length on the US image is illustrated by ‘+’ and a dashed line.
Ultrasound imaging is a key investigatory step in the evaluation of chronic kidney disease and kidney transplantation. It uses nonionizing radiation, is noninvasive, and generates real-time images, making it the ideal initial radiographic test for patients with abnormal kidney function.
A renal ultrasound examination can provide information regarding the gross anatomy and macrostructure of the renal parenchyma, and ultrasound imaging modalities based on Doppler or...
Renal parenchymal imaging, specifically ultrasound, often plays a role in the management of CKD by identifying reversible causes of renal dysfunction (e.g., obstruction) and aiding in the distinction between acute kidney injury (AKI) and CKD in a patient whose baseline renal function if unknown .
Ultrasound is commonly used in nephrology for diagnostic studies of the kidneys and lower urinary tract and to guide percutaneous procedures, such as insertion of hemodialysis catheters and kidney biopsy.