Ultrasound in Kidney Dysfunction (Native and Allograft Kidneys)

Ultrasound is the first radiological modality in assessing the kidney and urinary tract in children with acute or chronic kidney disease and also with kidney allograft dysfunction. The advantages of a bedside ultrasound in these cases lie in its portability, real-time imaging, ease of use, lack of ionising radiation, and adjustability. CT or MRI imaging in the young child might require sedation, and issues of radiation exposure or use of contrast material in renal dysfunction also preclude their use when assessing for kidney dysfunction in children. Ultrasound can help in the identification of aetiologies also in acute and chronic kidney disease, e.g. obstructive uropathy and nephrolithiasis. Especially in kidney allograft dysfunction, an ultrasound along with Doppler is essential to diagnose obstructive or vascular causes of dysfunction. Ultrasound is now the ‘standard of care’ while performing kidney biopsy in native and allograft kidneys (for acute or chronic dysfunction). This chapter shall illustrate common clinical cases and shall highlight how ultrasound and other radiological investigations help in the management of acute or chronic kidney dysfunction in both native and allograft kidneys.