Point of care ultrasonography in onco-nephrology: A stride toward better physical examination

Abstract

Onco-Nephrology is an emerging subspecialty of Nephrology that focuses on a broad spectrum of renal disorders that can arise in patients with cancer. It encompasses acute kidney injury (AKI), complex fluid, electrolyte, and acid-base disorders, as well as chronic kidney disease caused or exacerbated by cancer and/or its treatment. In many such scenarios including AKI and hyponatremia, objective evaluation of hemodynamics is vital for appropriate management. Point of care ultrasonography (POCUS) is a limited ultrasound exam performed at the bedside and interpreted by the treating physician intended to answer focused clinical questions and guide therapy. Compared to conventional physical examination, POCUS offers substantially higher diagnostic accuracy for various structural and hemodynamic derangements. In this narrative review, we provide an overview of the utility of POCUS enhanced physical examination for the Onconephrologist supported by the current evidence and our experience-based opinion.

Assessment of nephrology disease reporting to territory care hospital in Guntur, a prospective observational study

“…The kidneys are vulnerable to infection by blood borne microorganisms because of their high blood flow (20% of cardiac output). Objective hemodynamic examination is essential for proper therapy in several of these situations, including AKI and hyponatremia (1) .Agricultural communities, particularly manual laborers in dry, low land regions of Central America, Sri Lanka, and Southern India, are the main populations affected by chronic kidney disease of unknown origin, which is a progressive tubulointerstitial nephropathy (2) .Using the renal and hematology networks, a survey was circulated to gather insight on anticoagulant prescribing practice in the context of chronic kidney disease (CKD) throughout the UK (3) .The goal of this study was to identify the pattern of renal disease among kids who visited the hospital's pediatric nephrology clinic (4) .Here, an unbiased transcriptomic-driven method was employed to discover genomic pathways shared by subgroups of individuals with either focal segmental glomerulosclerosis or minimal change illness (FSGS) (5) .…”

Exploring the Applicability of Pre-Anesthetic Cardiac POCUS in Unexpected Conditions: Could it be Helpful?

“…Cardiac POCUS can play a pivotal role in the necessary preoperative assessment 37 . It is crucial to promptly exclude the presence of significant left ventricular (LV) dysfunction (e.g., cardiotoxicity due to chemotherapy).…”

Seeing through the myths: Practical aspects of diagnostic point-of-care ultrasound in nephrology

“…In addition, POCUS reduces fragmentation of care by allowing multiple evaluations performed during the same study. For example, a nephrologist evaluating a patient with suspected congestive nephropathy can assess cardiac function, right atrial pressure, presence or absence of venous congestion, pleural effusion, and ascites in a few minutes at bedside[ 5 , 6 ]. In contrast, without POCUS, obtaining answers to the same questions would require ordering a multitude of studies, including an echocardiogram, a chest radiograph, an abdominal sonogram, and a duplex study of the right upper quadrant and kidney.…”