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The article is professionally consulted by Master, Resident Doctor Nguyen Van Anh - Radiologist - Department of Diagnostic Imaging and Nuclear Medicine - Vinmec Times City International General Hospital.1. Overview of renal failure concepts, renal ultrasound
1.1 What is kidney failure? 2 kidneys of a normal healthy person have about 1 million kidney units. A person can lose up to 50% of the kidney units and still live a normal life. However, if more than 50% of the kidney units are lost and the kidneys are decompensated, then kidney failure will begin. Renal failure includes acute renal failure and chronic renal failure.Acute kidney failure: Can be identified through the amount of urine excreted during the day is less or more. If the patient has no urine or urine for 24 hours less than 100ml, it may be a warning sign that the patient has acute kidney failure. In addition, the patient may also have other signs such as facial edema, eyelid swelling, facial swelling due to water retention in the body; Chronic kidney failure: Symptoms are quite subtle, most patients only have fatigue, anorexia, anemia. If you do not pay attention, the patient will ignore these symptoms and do not go to the doctor early. Later, the patient may have vomiting, swelling of the limbs, high blood pressure, itching all over the body, blood in the urine or protein in the urine (when tested), ... 1.2 What is renal ultrasound? Renal ultrasound is a technique that uses sound waves to create images of the size, structure, or pathological signs of the kidneys. This technique is of high value in diagnosing localized kidney diseases such as kidney stones, renal cysts, renal abscesses, hydronephrosis or renal failure. The ultrasound method is a non-invasive, painless, patient-safe and highly accurate technique.
Characteristics showing normal healthy kidney ultrasound: The kidney is bean-shaped, the renal hilum is located inside, the size of the two kidneys are often not the same, about 9-12cm long, about 4-6cm wide and about 3-4cm thick, the border is regular, the left kidney parenchyma is triangular in shape (because the left side has the spleen pressing on it). Ultrasound will not be able to see the ureter in a healthy person. If the ureter is visible, it is usually due to a malformation of the ureter or an enlarged ureter. Ultrasonography also clearly shows renal arteries and veins.
2. Can ultrasound detect kidney failure?
In fact, ultrasonography gives vague results in diffuse kidney diseases such as acute glomerulonephritis, chronic glomerulonephritis, nephrotic syndrome, and renal amyloidosis. However, when the disease progresses to the stage of renal failure, seriously affecting the kidney size, ultrasound results are clear. Because then, the kidney size is smaller than normal.Therefore, it can be seen in clinical ultrasound that kidney failure can be detected. However, it is necessary to have multiple ultrasounds to get an accurate diagnosis, which helps to improve the effectiveness of treatment.
3. How does ultrasound assess kidney failure?
Ultrasound is the imaging modality used in the evaluation of acute or chronic renal failure, sometimes supplemented with Doppler ultrasonography. In fact, most cases of kidney failure have no known cause, so ultrasound can help identify part of the causes of kidney failure, thereby providing appropriate treatment. The problems that often lead to renal failure that can be identified on ultrasound are:Obstructive calyxial dilatation leading to renal failure: In patients with dilated renal tubules, the diagnosis should be confirmed or excluded. urinary tract obstruction. Kidney failure in the end stage: When 2 kidneys are less than 6cm in length, it is considered end stage kidney disease. At this time, the renal cortex is not stable enough to maintain the inherent function, the patient has severe renal failure. The ultrasound image shows that the body is atrophied in size, the renal medulla is hyperechoic, and the medulla oblongata is lost. Polycystic kidney disease: A disease often caused by genetics, easily causing kidney failure, requiring hemodialysis to treat. However, in cases where the kidneys are still of normal size and without pyelonephritis, ultrasonography is not enough to confirm the diagnosis but only provides some suggestions. For patients with normal kidney size, without dilated calyces, to diagnose the possibility of renal failure accurately, it is necessary to perform a kidney biopsy method. Biopsy was performed well under ultrasound guidance.
So, to the question of whether an ultrasound can tell if you have kidney failure, the answer is: Yes. Depending on the case, it may be necessary to apply only ultrasound or other techniques to confirm the diagnosis. And patients should absolutely follow the doctor's instructions for early detection and effective treatment.
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