Hand-carried Ultrasound to Assess Hydronephrosis

Not Applicable

Terminated

Brief Summary: This study evaluates if trainees can accurately rule out dilation of the renal collecting system on ultrasound (hydronephrosis) using hand-carried ultrasound (HCU). Trainees will undergo a short ultrasound training program. Patients will be adults that are hospitalized and have acute or subacute kidney dysfunction. The investigators will assess sensitivity, specificity, positive and negative predictive value of HCU compared to radiology performed ultrasound, and calculate potential cost savings to the patient and to the healthcare system.

Detailed Description: Hand-carried ultrasound is an increasingly popular imaging modality and is widely used by emergency physicians, intensivists, trauma doctors and cardiologists. Renal ultrasonography is commonly ordered for patients with acute kidney injury, with a main focus on identifying obstruction of the collecting system, a rare but potentially reversible cause of acute kidney injury.

This study's aim is to evaluate if nephrology and internal medicine trainees can accurately rule out dilation of the renal collecting system on ultrasound (hydronephrosis) using hand-carried ultrasound (HCU). Trainees will undergo a short, uniform and well described ultrasound training program. Patients will be adults that are hospitalized and have acute or subacute kidney dysfunction. The investigators will assess sensitivity, specificity, positive and negative predictive value of HCU compared to radiology performed ultrasound, and calculate potential cost savings to the patient and to the healthcare system.

Recruitment & Eligibility

Inclusion Criteria

Age more than 18 years old
Inpatient admission to Barnes Jewish Hospital (BJH)
Patient has a diagnosis of Acute kidney injury (AKI) or Acute kidney Disease (AKD)
Renal ultrasound ordered or performed within the past 4 hours

Exclusion Criteria

Arm && Interventions

Group	Intervention	Description
Hand-carried ultrasound arm	Hand-carried ultrasound	This is the only arm of the study. It will be comprised of 154 inpatients who had a renal ultrasound ordered or performed within the past 4 hours. The intervention will be performing hand-carried ultrasound to evaluate for presence and degree of hydronephrosis.

Primary Outcome Measures

Name	Time	Method
Number of Participants With Absence of Hydronephrosis	Through study completion, up to an average of 1 day	The number of participants for whom none of the kidneys imaged with hand-carried ultrasound have hydronephrosis (dilation of the collecting system) is reported

Secondary Outcome Measures

Name	Time	Method
Direct Costs of Hand-carried Ultrasound	Through study completion, up to an average of 1 day	Direct costs in $ of hand-carried ultrasound will be calculated and compared to the costs of radiology performed ultrasound. For hand-carried ultrasound, this will include costs of purchasing the device, training costs, yearly depreciation of the hand-carried ultrasound device. For radiology performed ultrasound, this will include the sonographer's fee, radiologist fee for interpretation of the result, transportation fee by hospital transport and depreciation of the ultrasound machine.

Locations (1): Barnes Jewish Hospital
🇺🇸
Saint Louis, Missouri, United States

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