Acute tubular necrosis echocardiography or ultrasound

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Chandrakala Yannam, MD [2]

Ultrasound with doppler imaging can be helpful in the diagnosis of acute tubular necrosis. Findings on an ultrasound include normal or increased kidney size, alterations in cortical echogenicity and increased RI. There are no echocardiography findings associated with acute tubular necrosis. However, an echocardiography may be helpful in the diagnosis of complications of acute tubular necrosis.

• Ultrasound with doppler imaging may be helpful in the diagnosis of acute tubular necrosis. Findings on an ultrasound and doppler imaging suggestive of acute tubular necrosis include:^[1][2][3]
  • Normal or symmetrically enlarged kidneys
  • Variable cortical echogenicity
  • Increased parenchymal thickness
  • On doppler, diastolic blood flow is decreased resuling in increased resistive index ≥0.75.  
  • Resistive Index ≥0.75 has 91.3% sensitivity and 85.2% specificity to distinguish acute tubular necrosis from prerenal azotemia.^[4]
  • Ulrasound can also used to detect renal calculi and obstructive uropathy.
• There are no echocardiography findings associated with acute tubular necrosis. However, an echocardiography may be helpful in the diagnosis of complications of acute tubular necrosis, which include:
  • Hyperkalemia
  • Arrhythmias

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