Acute renal failure in the intensive care unit. Part 1

Summary

In the patient who presents with ARF of unclear etiology the initial radiologic evaluation should be by means of renal ultrasonography. This will provide information regarding kidney size and most importantly, obstruction. If obstruction is present this can be relieved by percutaneous nephrostomy and further evaluated by antegrade pyelography. More detailed information regarding etiology of an obstruction can be obtained by CT scan. In the uncommon situation when vascular occlusion is suspected this can be evaluated with a radionucleotide scan and/or arteriography. Arteriography can also be employed for cases of renal trauma or if polyarteritis nodosa is suspected. There is virtually no role for IVU in the evaluation of ARF, except when renal trauma is suspected, and a limited role for retrograde pyelography.