ACR logo

Appropriateness Criteria

Reference Study Type Patients/Events Study Objective(Purpose of Study) Study Results Study Quality
1. Palevsky PM, Liu KD, Brophy PD, et al. KDOQI US commentary on the 2012 KDIGO clinical practice guideline for acute kidney injury. [Review]. Am J Kidney Dis. 61(5):649-72, 2013 May. Review/Other-Dx Not applicable To provide commentary and summarize the KDIGO recommendation statements along with the supporting rationales and comments on their applicability to clinical practice in the United States. No results stated in abstract. 4
2. Kellum JA, Lameire N, KDIGO AKI Guideline Work Group. Diagnosis, evaluation, and management of acute kidney injury: a KDIGO summary (Part 1). [Review]. Crit Care. 17(1):204, 2013 Feb 04. Review/Other-Dx N/A To present here a shortened version of the guideline focusing on definitions, risk assessment, evaluation, and nondialytic management. No results stated in abstract. 4
3. Kidney International. KDIGO Clinical Practice Guideline for Acute Kidney Injury.  Available at: http://kdigo.org/wp-content/uploads/2016/10/KDIGO-2012-AKI-Guideline-English.pdf. Review/Other-Dx N/A To provide clinical Guidelines for Acute Kidney Injury. No results stated in abstract. 4
4. Podoll A, Walther C, Finkel K. Clinical utility of gray scale renal ultrasound in acute kidney injury. BMC Nephrology. 14:188, 2013 Sep 08. Observational-Dx 1471 patients To determine the frequency of abnormal findings on Renal ultrasound (RUS), particularly the presence of hydronephrosis, and the clinical characteristics associatedwith higher likelihood of finding urinary tract obstruction. Over the 3-year period, 1471 renal ultrasounds were performed of which 55% (810) were for evaluation of acute kidney injury. Renal ultrasound was normal in 62% (500 of 810) of patients. Hydronephrosis was detected in only 5% (42 of 810) of studies and in only 2.3% (19 of 810) of the cases was obstructive uropathy considered the cause of acute kidney injury. The majority of these patients (14 of 19) had a medical history suggestive of urinary tract obstruction. Less than 1% of patients (5 of 810) had urinary tract obstruction on ultrasound without a suggestive medical history. Most other ultrasound findings were incidental and did not establish an etiology for the acute kidney injury. 3
5. Inker LA, Astor BC, Fox CH, et al. KDOQI US commentary on the 2012 KDIGO clinical practice guideline for the evaluation and management of CKD. Am J Kidney Dis. 2014;63(5):713-735. Review/Other-Dx N/A To provide clinical practice guideline for the evaluation and management of chronic kidney disease (CKD). No results stated in abstract. 4
6. Mendu ML, Lundquist A, Aizer AA, et al. The usefulness of diagnostic testing in the initial evaluation of chronic kidney disease. JAMA Intern Med. 2015;175(5):853-856. Review/Other-Dx N/A To review the usefulness of diagnostic testing in the initial evaluation of chronic kidney disease No results stated in abstract. 4
7. The National Institute of Diabetes and Digestive and Kidney Diseases. Health Information Center. Estimating Glomerular Filtration Rate.  Available at: https://www.niddk.nih.gov/health-information/communication-programs/nkdep/laboratory-evaluation/glomerular-filtration-rate/estimating. Review/Other-Dx N/A To provide information on estimating glomerular filtration rate No abstract available 4
8. Vassalotti JA, Centor R, Turner BJ, Greer RC, Choi M, Sequist TD. Practical Approach to Detection and Management of Chronic Kidney Disease for the Primary Care Clinician. Am J Med. 2016;129(2):153-162 e157. Review/Other-Dx N/A To provide Practical Approach for Detection and Management of Chronic Kidney Disease for the Primary Care Clinician No results stated in abstract. 4
9. American College of Radiology. Manual on Contrast Media. Available at: https://www.acr.org/Clinical-Resources/Contrast-Manual. Review/Other-Dx N/A To assist radiologists in recognizing and managing risks associated with the use of contrast media. No abstract available. 4
10. Piscaglia F, Nolsoe C, Dietrich CF, et al. The EFSUMB Guidelines and Recommendations on the Clinical Practice of Contrast Enhanced Ultrasound (CEUS): update 2011 on non-hepatic applications. Ultraschall Med 2012;33:33-59. Review/Other-Dx N/A To provide guidelines and recommendations on the clinical practice of contrast enhanced ultrasound (CEUS) on non-hepatic applications. No abstract available 4
11. Fernandez CP, Ripolles T, Martinez MJ, Blay J, Pallardo L, Gavela E. Diagnosis of acute cortical necrosis in renal transplantation by contrast-enhanced ultrasound: a preliminary experience. Ultraschall in der Medizin. 34(4):340-4, 2013 Aug. Observational-Dx 5 patients To evaluate the use of contrast-enhanced ultrasound (CEUS) for diagnosis of cortical necrosis in renal allografts. Five patients with an age range between 30 and 48 years. Post-transplant color Doppler ultrasound showed decreased renal parenchymal vascularization and difficulty to find the spectral waveforms with resistive indexes greater than 0.7 in 4 of 5 patients. CEUS showed enhancement of the main arteries, followed by the enhancement of medullary pyramids, but with an unenhanced peripheral cortical continuous band viewed in all phases, a similar finding to the peripheral rim sign, pathognomonic of cortical necrosis on computed tomography (CT) or magnetic resonance imaging (MRI). The pathologic assessment showed violet kidneys macroscopically with hemorrhagic foci in the outer cortical that drew a well-defined band, findings agreed with CEUS findings. 3
12. McKay H, Ducharlet K, Temple F, Sutherland T. Contrast enhanced ultrasound (CEUS) in the diagnosis of post-partum bilateral renal cortical necrosis: a case report and review of the literature. [Review]. Abdom Imaging. 39(3):550-3, 2014 Jun. Review/Other-Dx N/A To present a case of bilateral postpartum renal cortical necrosis diagnosed with the aid of Contrast enhanced ultrasound (CEUS). No results stated in abstract. 4
13. Girometti R, Stocca T, Serena E, Granata A, Bertolotto M. Impact of contrast-enhanced ultrasound in patients with renal function impairment. World J Radiol. 9(1):10-16, 2017 Jan 28. Observational-Dx 91 patients To investigate the role of contrast enhanced ultrasound (CEUS) in evaluating patients with renal function impairment (RFI) showing: (1) acute renal failure (ARF) of suspicious vascular origin; or (2) suspicious renal lesions. In the first group, CEUS detected renal infarction or cortical ischemia in 18/50 patients (36%; 95%CI: 23.3-50.9) and 1/50 patients (2%; 95%CI: 0.1-12), respectively. The detection rate of infarction was significantly higher (P = 0.0002; McNemar test) compared to color Doppler ultrasonography (10%). No vascular causes of ARF were identified in the remaining 31/50 patients (62%). In the second group, CEUS detected 41 lesions on 39 patients, allowing differentiation between solid lesions (21/41; 51.2%) vs complex cysts (20/41; 48.8%), and properly addressing 15/39 patients to intervention when feasible based on clinical conditions (surgery and cryoablation in 13 and 2 cases, respectively). Cysts were categorized Bosniak II, IIF, III and IV in 8, 5, 4 and 3 cases, respectively. In the remaining two patients, CEUS found 1 pseudolesion and 1 subcapsular hematoma. 3
14. American College of Radiology. ACR–NASCI–SIR–SPR Practice Parameter for the Performance and Interpretation of Body Computed Tomography Angiography (CTA). Available at: https://www.acr.org/-/media/ACR/Files/Practice-Parameters/body-cta.pdf. Review/Other-Dx N/A Guidance document to promote the safe and effective use of diagnostic and therapeutic radiology by describing specific training, skills and techniques. No abstract available. 4
15. Ripolles T, Agramunt M, Errando J, Martinez MJ, Coronel B, Morales M. Suspected ureteral colic: plain film and sonography vs unenhanced helical CT. A prospective study in 66 patients. Eur Radiol. 2004;14(1):129-136. Observational-Dx 66 patients Prospective study to compare value of KUB plus US with nonenhanced CT for the diagnosis of ureteral colic in patients with acute flank pain. CT had greater sensitivity (93% vs 79%) and NPV (71% vs 46%) for the detection of lithiasis. Combination of lithiasis plus obstructive signs showed sensitivity and a specificity of 100% for CT and of 100% and 90%, respectively, for US. CT is the most accurate technique for the detection of ureteral lithiasis but the combination of radiograph and US is an alternative to nonenhanced CT with a lower sensitivity and radiation dose that has a good practical value. 2
16. Gupta S, Singh AH, Shabbir A, Hahn PF, Harris G, Sahani D. Assessing renal parenchymal volume on unenhanced CT as a marker for predicting renal function in patients with chronic kidney disease. Acad Radiol. 19(6):654-60, 2012 Jun. Observational-Dx 26 patients To estimate renal volume in chronic kidney disease (CKD) patients using a semiautomated software and compare them with split renal function estimates from radionuclide renogram (RR). A moderately positive correlation was found between renal volume obtained on unenhanced computed tomography (CT) and estimated glomerular filtration rate [eGFR] (r = 0.65, P < .0001), whereas a significantly high correlation with split function estimates from RR (r = 0.95, P < .001) was found. Bland-Altman analysis revealed a good agreement between renal volume from CT and renal function from RR (34/36 observations were within 95% CI and there were two outliers). Correlation between volumes obtained from unenhanced and enhanced CT scans was also significant (r = 0.96). 3
17. Mehta RL, Pascual MT, Soroko S, et al. Spectrum of acute renal failure in the intensive care unit: the PICARD experience. Kidney Int. 2004; 66(4):1613-1621. Observational-Dx 618 patients To describe the methods of patient selection and data acquisition, and the spectrum of collected clinical and process variables in addition to reporting on major study outcomes, focusing on differences by clinical site, dialysis requirement, and etiology of acute renal failure. The mean age was 59.5 years, 41% were women, and 20% were of minority race or ethnicity. There was extensive comorbidity; 30% had chronic kidney disease, 37% had coronary artery disease, 29% had diabetes mellitus, and 21% had chronic liver disease. Acute renal failure was accompanied by extrarenal organ system failure in most patients, even those who did not require dialysis. Three hundred and ninety-eight (64%) patients required dialysis. The in-hospital mortality rate was 37%, and the rate of mortality or nonrecovery of renal function was 50%. The median hospital length of stay was 25 days (26 days, excluding patients who died). 3
18. Solar M, Zizka J, Krajina A, et al. Comparison of duplex ultrasonography and magnetic resonance imaging in the detection of significant renal artery stenosis. Acta Medica (Hradec Kralove). 2011;54(1):9-12. Observational-Dx 94 patients To evaluate duplex ultrasonography (DUS) and magnetic resonance angiography (MRA) in detection of haemodynamically significant renal artery stenosis (RAS). Arterial supply of 186 kidneys in 94 patients was evaluated. DSA revealed significant RAS in 61 kidneys evaluated. DUS was not able to examine arterial supply in 18 kidneys of 13 patients. In the detection of significant RAS, DUS was characterized by sensitivity and specificity of 85% and 84%. MRA achieved satisfactory imaging quality in all but one kidney evaluated. The sensitivity and specificity of MRA in the detection of significant RAS was 93% and 93%, respectively. 2
19. Albert TS, Akahane M, Parienty I, et al. An international multicenter comparison of time-SLIP unenhanced MR angiography and contrast-enhanced CT angiography for assessing renal artery stenosis: the renal artery contrast-free trial. AJR Am J Roentgenol. 2015;204(1):182-188. Experimental-Dx 75 patients To assess determine if time-SLIP unenhanced MRA is accurate and robust for assessing the renal arteries for stenosis in comparison with contrast-enhanced CT angiography (CTA). Unenhanced MRA image quality was excellent for 56 of 75 patients (75%) and good for 16 of 75 patients (21%). CTA was used as the reference standard and showed that 23 of 161 renal arteries (14.3%) had stenosis > 50%. Unenhanced MRA correctly classified 17 of the 23 renal arteries with > 50% stenosis and correctly classified 128 of the 138 renal arteries as not having disease (</= 50% stenosis) to yield a sensitivity of 74%, specificity of 93%, and accuracy of 90% (chi(2) = 0.56; p = 0.45, no statistically significant difference). Of the 16 misclassified arteries, only three had a clinically relevant misclassification (CTA >/= 70% stenosis and unenhanced MRA </= 50% stenosis or unenhanced MRA >/= 70% stenosis and CTA </= 50% stenosis). On average, measured stenotic severity (n = 28 arteries) was similar for unenhanced MRA (64% +/- 17%) and CTA (62% +/- 16%) (p = 0.51). 1
20. Angeretti MG, Lumia D, Cani A, et al. Non-enhanced MR angiography of renal arteries: comparison with contrast-enhanced MR angiography. Acta Radiol. 54(7):749-56, 2013 Sep. Observational-Dx 63 patients To assess the accuracy of steady-state free-precession (SSFP) non-contrast-enhanced magnetic resonance angiography (NC-MRA) by using a 1.5 T MR scanner for the detection of renal artery stenosis, in comparison with breath-hold contrast-enhanced magnetic resonance angiography (CE-MRA) as the reference standard. Maximum intensity projection (MIP) image quality was considered better for NC-MRA. NC-MRA identified 143 of 144 (99.3%) arteries detected by CE-MRA (an accessory artery was not identified). Fourteen stenoses were detected by CE-MRA (11 atherosclerotic, 3 dysplastic) with four of 14 (28.5%) significant stenosis. Bland-Altman plot demonstrated an excellent concordance between NC-MRA and CE-MRA; particularly, the reader A evaluated correctly all investigated arteries, while over-estimation of two stenoses occurred for reader B. Regarding NC-MRA, inter-observer agreement was excellent. 2
21. Gillis KA, McComb C, Patel RK, et al. Non-Contrast Renal Magnetic Resonance Imaging to Assess Perfusion and Corticomedullary Differentiation in Health and Chronic Kidney Disease. Nephron. 133(3):183-92, 2016. Observational-Dx 17 patients To investigate the utility of Arterial spin labelling (ASL) Magnetic Resonance Imaging (MRI) in patients with chronic kidney disease (CKD). T1 was higher in chronic kidney disease (CKD) within cortex and whole kidney, and there was association between T1 time and estimated glomerular filtration rate (eGFR). No association was seen between kidney size and volume and either T1, or Arterial spin labelling (ASL) perfusion. Perfusion was lower in CKD in cortex (136 +/- 37 vs. 279 +/- 69 ml/min/100 g; p < 0.001) and whole kidney (146 +/- 24 vs. 221 +/- 38 ml/min/100 g; p < 0.001). There was significant, negative, association between T1 longitudinal relaxation time and ASL perfusion in both the cortex (r = -0.75, p < 0.001) and whole kidney (r = -0.50, p < 0.001). There was correlation between eGFR and both cortical (r = 0.73, p < 0.01) and whole kidney (r = 0.69, p < 0.01) perfusion. 3
22. Zhou HY, Chen TW, Zhang XM. Functional Magnetic Resonance Imaging in Acute Kidney Injury: Present Status. [Review]. Biomed Res Int. 2016:2027370, 2016. Review/Other-Dx N/A To illustrate the principle, application, and role of the techniques of functional renal magnetic resonance (MR) imaging, including blood oxygen level-dependent imaging, arterial spin labeling, and diffusion-weighted MR imaging, in the management of Acute kidney injury (AKI). No results stated in abstract. 4
23. Francois M, Tostivint I, Mercadal L, Bellin MF, Izzedine H, Deray G. MR imaging features of acute bilateral renal cortical necrosis. Am J Kidney Dis. 35(4):745-8, 2000 Apr. Review/Other-Dx 2 cases To report two cases in which magnetic resonance imaging (MRI) evidenced characteristic features of Bilateral renal cortical necrosis (BRCN), which were confirmed by histological findings and arteriography and correlated with clinical evolution. No results stated in abstract. 4
24. Fulgham PF, Assimos DG, Pearle MS, Preminger GM. Clinical effectiveness protocols for imaging in the management of ureteral calculous disease: AUA technology assessment. [Review]. J Urol. 189(4):1203-13, 2013 Apr. Review/Other-Dx N/A To review the optimal use of imaging in the evaluation and treatment of patients with suspected or documented ureteral stones. Based on protocols (in the form of decision tree algorithms), noncontrast computerized tomography is recommended to establish the diagnosis in most cases, with a low energy protocol advocated if body habitus is favorable. Conventional radiography and ultrasound are endorsed for monitoring the passage of most radiopaque stones as well as for most patients undergoing stone removal. Other studies may be indicated based on imaging findings, and patient, stone and clinical factors. 4
25. Blaustein DA, Myint MM, Babu K, Avram MM, Chandramouli BS. The role of technetium-99m MAG3 renal imaging in the diagnosis of acute tubular necrosis of native kidneys. Clin Nucl Med. 27(3):165-8, 2002 Mar. Review/Other-Dx 4 The authors describe four patients with acute renal failure in whom MAG3 renal imaging reliably identified acute tubular necrosis. MAG3 renal imaging reliably identified acute tubular necrosis in the four patient sample, as confirmed by follow-up kidney biopsies. In contrast to the poor parenchymal uptake observed in glomerulonephritis and interstitial nephritis, MAG3 shows a distinctive pattern in patients with acute tubular necrosis. 4
26. Ellenbogen PH, Scheible FW, Talner LB, Leopold GR. Sensitivity of gray scale ultrasound in detecting urinary tract obstruction. AJR Am J Roentgenol 1978;130:731-3. Observational-Dx 67 patients To determine the reliability of gray scale ultrasound in detecting urinary tract obstruction, Hydronephrosls was correctly diagnosed by ultrasound In 46 of 47 kIdneys shown to be obstructed on urography, for a sensitivity of 98%. Our results show that when obstruction Is the sole clinical question, ultrasound is an effective screening test. Thus many patients with a variety of medical diseases of the kidney can be spared excretory urography. 2
27. Gamss R, Stein MW, Rispoli JM, et al. What Is the Appropriate Use of Renal Sonography in an Inner-City Population With New-Onset Acute Kidney Injury?. J Ultrasound Med. 34(9):1639-44, 2015 Sep. Review/Other-Dx 274 patients To determine the prevalence of hydronephrosis in patients who underwent renal sonography for new-onset acute kidney injury (AKI) and to identify clinical factors predictive of hydronephrosis. Sonography showed hydronephrosis in 28 patients (10%); 5 (18%) had subsequent interventions. In a multivariable logistic regression model with the outcome being hydronephrosis, all considered risk factors (pelvic mass, prior renal or pelvic surgery, and neurogenic bladder) were significantly associated with hydronephrosis (odds ratio, 6.4; 95% confidence interval, 2.7-15.4; P < .001) when adjusting for age and diabetes mellitus. Diabetes had a negative predictive value for hydronephrosis. No diabetic patients younger than 85 years and without clinical risk factors had hydronephrosis. 4
28. Keyserling HF, Fielding JR, Mittelstaedt CA. Renal sonography in the intensive care unit: when is it necessary? J Ultrasound Med. 2002; 21(5):517-520. Review/Other-Dx 105 examinations; 104 patients To evaluate the efficacy of renal sonography performed in intensive care units on patients with the diagnosis of acute or acute-on-chronic renal failure. Only 1 study had positive results for hydronephrosis, which was graded as mild. Incidental findings not immediately affecting patient care and including ascites and simple renal cysts were identified in 91 patients. The estimated total cost of the examinations was $13,350.75. 4
29. Licurse A, Kim MC, Dziura J, et al. Renal ultrasonography in the evaluation of acute kidney injury: developing a risk stratification framework. Arch Intern Med. 2010; 170(21):1900-1907. Observational-Dx derivation sample of 200 patients; validation sample of 797 patients To create a stratification system that would help clinicans ascertain the risk of renal obstruction among those with acute kidney injury (AKI). In a derivation sample of 200 patients, 7 factors were found to be associated with HN: history of HN; recurrent urinary tract infections; diagnosis consistent with obstruction; nonblack race; and absence of the following: exposure to nephrotoxic medications, congestive heart failure, or prerenal AKI. Among 797 patients in the validation sample (mean age, 65.6 years), 10.6% had HN and 3.3% had HNRI. Of 223 patients in the low-risk group, 7 (3.1%) had HN and 1 (0.4%) had HNRI (223 patients needed to be screened to find 1 case of HNRI). In this group, there were 0 incidental findings on RUS unknown to the clinical team. In the higher-risk group, 15.7% had HN and 4.7% had HNRI. 3
30. Jovanovic D, Gasic B, Pavlovic S, Naumovic R. Correlation of kidney size with kidney function and anthropometric parameters in healthy subjects and patients with chronic kidney diseases. Ren Fail. 35(6):896-900, 2013 Jul. Observational-Dx 49 patients; 46 controls To compare the kidney echosonograpic characteristics with the kidney function and anthropometric characteristics in healthy subjects and patients with the chronic kidney disease (CKD). There was no significant difference in age and sex between two groups but serum creatinine concentration was significantly higher (218.8 vs. 84.5 mumol/L) and Ccr significantly lower (66.44 vs. 94.20 mL/min, C--G) in patient group. The left kidney was larger in both groups, but the only significant difference was in kidney depth (p < 0.01). There was significant correlation between all measured kidney dimensions, volume, parenchymal thickness and serum creatinine concentration and Ccr (C--G) in patient group. In the controls, there was no significant correlation between the kidney size and function, but there was a significant correlation between the kidney width, depth, volume and patients' age and anthropometric parameters. On the contrary, all analyzed parameters of kidney size, except volume, did not correlate significantly with the anthropometric parameters of patients. 3
31. Takata T, Koda M, Sugihara T, et al. Left Renal Cortical Thickness Measured by Ultrasound Can Predict Early Progression of Chronic Kidney Disease. Nephron. 132(1):25-32, 2016. Observational-Dx 158 patients; 18 controls To investigate the relationship between the changes in the renal cortex and medulla and renal function. We found stepwise associations in renal length, cortical thickness and parenchymal thickness with decreased renal function. Medullary thickness showed no changes among groups 1-3. Multiple linear regression analysis including sex, age and renal US parameters showed that only renal length was an independent predictor of renal function. When analyzed in groups 1-3, cortical thickness was the strongest associated parameter. Lower cortical left/right ratio (left cortical thickness/right cortical thickness) showed a stepwise association with a decrease in renal function. 3
32. AbuRahma AF, Srivastava M, Mousa AY, et al. Critical analysis of renal duplex ultrasound parameters in detecting significant renal artery stenosis. J Vasc Surg. 2012; 56(4):1052-1059, 1060 e1051; discussion 1059-1060. Observational-Dx 313 patients (606 renal arteries) To compare RDU imaging vs. angiography and assess various published Doppler criteria to detect significant renal artery stenosis (RAS). The mean PSVs and RARs for normal, <60%, and >/=60% stenosis were 173, 236, and 324 cm/s (P < .0001), and 2.2, 2.9, and 4.5, respectively (P < .0001). The PSV cutoff value that provided the best overall accuracy for >/=60% stenosis was 285 cm/s, with a sensitivity, specificity, and overall accuracy of 67%, 90%, and 81%, respectively. The RAR cutoff value with the best overall accuracy for >/=60% stenosis was 3.7, with a sensitivity, specificity, and overall accuracy of 69%, 91%, and 82%, respectively. 2
33. Guinot PG, Bernard E, Abou Arab O, et al. Doppler-based renal resistive index can assess progression of acute kidney injury in patients undergoing cardiac surgery. J Cardiothorac Vasc Anesth. 27(5):890-6, 2013 Oct. Observational-Dx 82 patients To test whether assessment of renal resistive index measured after cardiac surgery (RRI(T0)) can diagnose persistent acute kidney injury (AKI). Out of the 82 patients, 15 (18%) developed persistent AKI, and 6 (7%) developed transient AKI. The median value and time-course of RRI were significantly different between patients with transient AKI and persistent AKI. Doppler-based RRI(T0) predicted persistent AKI with an area under the receiver-operating characteristic curve of 0.93 (95% confidence interval: 0.85-0.98, p<0.0001). The optimal cut-off of RRI was 0.73 (95% confidence interval: 0.73-0.75). The gray-zone approach identified a range of RRI values between 0.72 and 0.75 in 14% of patients. 2
34. Marty P, Ferre F, Labaste F, et al. The Doppler renal resistive index for early detection of acute kidney injury after hip fracture. Anaesth Crit Care Pain Med. 35(6):377-382, 2016 Dec. Observational-Dx 48 patients To assess the accuracy of the Doppler renal resistive index (RI) in detecting acute kidney injury (AKI) at an early stage after hip fracture surgery. Twenty-nine patients (60%) developed AKI during the first five postoperative days, without need for dialysis. The RI was increased in patients who developed postoperative AKI 0.68 (0.67-0.71) vs. 0.72 (0.7-0.73); P=0.014 for the preoperative index; and 0.6 (0.58-0.68) vs. 0.74 (0.71-0.76); P<0.0001 for the postoperative index. A postoperative index superior or equal to 0.706 is a marker for the early detection of AKI with a high sensitivity and a high specificity (76% and 89%, respectively). 2
35. Ninet S, Schnell D, Dewitte A, Zeni F, Meziani F, Darmon M. Doppler-based renal resistive index for prediction of renal dysfunction reversibility: A systematic review and meta-analysis. [Review]. Journal of Critical Care. 30(3):629-35, 2015 Jun. Meta-analysis 9 studies To investigate the diagnostic performance of resistive index (RI) in predicting short-term reversibility of acute kidney injury (AKI). Among the 154 unique articles identified, 9 studies were included. Of the 176 patients in these studies with elevated RI or pulsatility index, 146 (83%) had a persistent AKI vs 44 (16%) of the 273 patients with normal values. Elevated RI or pulsatility index was associated with an increased risk of persistent AKI (odds ratio, 29.85; 95% confidence interval [CI], 8.73-102.16; P < .00001) with significant heterogeneity (I(2) = 75.0%, P < .0001). The pooled sensitivity and specificity were 0.83 (95% CI, 0.77-0.88) and 0.84 (95% CI, 0.79-0.88). The summary positive and negative likelihood ratios were 4.9 (95% CI, 2.44-9.87) and 0.21 (95% CI, 0.11-0.41). Good
36. Boddi M, Bonizzoli M, Chiostri M, et al. Renal Resistive Index and mortality in critical patients with acute kidney injury. Eur J Clin Invest. 46(3):242-51, 2016 Mar. Observational-Dx 125 patients To investigate the association between Renal Resistive Index (RRI) and persistent acute kidney injury (AKI) at discharge was investigated. At AKI diagnosis, RRI was 0.77 (0.70-0.88) in survivors and 0.85 in nonsurvivors (0.79-0.94) (P = 0.002). RRI values were significantly associated with ICU death (OR = 1.63-95% CI 1.06-2.49, P = 0.025). A RRI cut-off value of 0.77 was identified by receiver operating characteristic curve. Multivariate analysis selected RRI and abdominal hypertension as strongest predictors of AKI mortality. At AKI diagnosis, RRI was 0.78 (0.70-0.85) or 0.85 (0.73-0.92) (P = 0.026) in patients with or without persistent AKI at discharge. Multivariate analysis selected RRI at AKI diagnosis as the strongest predictor of persistent AKI. 2
37. Grun OS, Herath E, Weihrauch A, et al. Does the measurement of the difference of resistive indexes in spleen and kidney allow a selective assessment of chronic kidney injury?. Radiology. 264(3):894-902, 2012 Sep. Observational-Dx 152 controls; 290 paients To determine whether the difference of resistive indexes (RIs) in spleen and kidney (DI-RISK) is a more specific ultrasonographic (US) marker of intrarenal parenchymal damage than intrarenal RI alone. Healthy subjects had a mean age of 34.3 years +/- 8.7, and patients with chronic kidney disease had a mean age of 65.0 years +/- 12.3 (P < .001). In healthy subjects, both renal and splenic RIs were associated with IMT (renal RI: r = 0.19, P = .022; splenic RI: r = 0.23, P = .005); there was no correlation between DI-RISK and IMT (r = -0.10, P = .215). Similarly, in patients with chronic kidney disease, renal and splenic RIs correlated with IMT (renal RI: r = 0.33, P < .001; splenic RI: r = 0.30, P = .001). DI-RISK was associated with the estimated glomerular filtration rate (eGFR; r = -0.19, P = .001) but not with IMT (r = 0.08, P = .174). At multivariate regression analysis, DI-RISK was independently associated with eGFR but not with extrarenal factors. 3
38. Balk EM, Raman G, Adam GP, et al. Renal Artery Stenosis Management Strategies: An Updated Comparative Effectiveness Review. Rockville (MD); 2016. Review/Other-Dx N/A To review Renal Artery Stenosis Management Strategies No results stated in abstract 4
39. Mendu ML, Lundquist A, Aizer AA, et al. Clinical predictors of diagnostic testing utility in the initial evaluation of chronic kidney disease. Nephrology. 21(10):851-9, 2016 Oct. Observational-Dx 1,487 patients To identify clinical criteria to guide a rational diagnostic approach for the initial evaluation of chronic kidney disease (CKD). We identified clinical criteria predictive of high yield for paraprotein-related testing (one of the following: history of monoclonal disease, high risk of CKD progression, hypercalcemia or haemoglobin < 10.6), and clinical criteria predictive of high yield for glomerulonephritis testing (one of the following: abnormal urine sediment, 3+ or greater hematuria or proteinuria > 500 mg/gm). A prior history of hydronephrosis and renal artery stenosis was predictive of high yield of abnormal renal ultrasound. Higher yield of testing was associated with higher risk progression categories for antinuclear antibody (ANA), serum protein electrophoresis (SPEP), urine sediment, calcium, parathyroid hormone (PTH), haemoglobin, iron and ferritin. We estimate that initial CKD evaluation costs range from $28 to $109 million/year in US-Medicare expenditure. 4
40. Lucisano G, Comi N, Pelagi E, Cianfrone P, Fuiano L, Fuiano G. Can renal sonography be a reliable diagnostic tool in the assessment of chronic kidney disease?. J Ultrasound Med. 34(2):299-306, 2015 Feb. Observational-Dx 72 patients To postulate that if the conventionally measured renal sonographic parameters (pole-to-pole length, width, and parenchymal thickness) are taken according to standardized rules and corrected for body height, their association with kidney function could be strengthened, thus helping validate renal sonographic information for a better assessment of chronic kidney disease (CKD) status. Parenchymal thickness and renal length showed the highest correlation level with the glomerular filtration rate (GFR). This significant correlation, however, was greatly ameliorated by the correction for patients' body height (r = 0.537; P < .001; r = 0.510; P < .001, respectively). Of note, the product of these two parameters corrected for body height showed the best degree of correlation with the GFR (r = 0.560; P < .001), as confirmed by analysis of variance after subdivision of the population into chronic kidney disease (CKD) stage groups according to the GFR. Receiver operating characteristic curve analysis for discrimination of a GFR of less than 60 mL/min indentified the combined parameter as the one with the highest area under the curve (0.78; 95% confidence interval, 0.66-0.89), followed renal length corrected for height (area under the curve, 0.77; 95% confidence interval, 0.66-0.88). 3
41. Makusidi MA, Chijioke A, Braimoh KT, Aderibigbe A, Olanrewaju TO, Liman HM. Usefulness of renal length and volume by ultrasound in determining severity of chronic kidney disease. Saudi J Kidney Dis Transpl. 25(5):1117-21, 2014 Sep. Observational-Dx 322 patients To determine the correlation of renal ultrasonic parameters and degree of kidney function among chronic kidney disease patients seen at the Nephrology unit of the University of Ilorin Teaching Hospital (UITH) Ilorin, we studied 322 patients. The results were analyzed with specific reference to socio-demography and correlating renal length and volume with estimated glomerular filtration rate. The male to female ratio was 2:1, with an age range from 20 to 80 years and mean age of 45.06 (+/-13.0) years. The serum creatinine levels ranged from 201 to 1205 mumol/L, with a mean of 388 +/- 168 mumol/L, while the estimated glomerular filtration rate (eGFR) ranged from 3.77 to 44.32 mL/min, with a mean of 18.2 +/- 7.19 mL/min. The right and left renal lengths ranged from 6.9 to 13.0 cm, with a mean of 9.11 +/- 1.06, and 6.5-13.4 cm, with a mean of 9.23 +/- 1.07 cm, respectively. The mean volumes of the right and left kidneys were 98.6 +/- 41.9 cm 3 and 105 +/- 46.2 cm 3 , respectively. The Pearson correlation of the right and left kidneys length to eGFR were -0.197 and -0.137 respectively, while that of the right and left kidney volume to eGFR were -0.122 and -0.043, respectively. 3
42. Yaprak M, Cakir O, Turan MN, et al. Role of ultrasonographic chronic kidney disease score in the assessment of chronic kidney disease. Int Urol Nephrol. 49(1):123-131, 2017 Jan. Observational-Dx 120 patients To investigate the association between estimated glomerular filtration rate (e-GFR) and ultrasonographic chronic kidney disease (CKD) score calculated via these ultrasonographic parameters. The mean age of patients was 63.34 +/- 14.19 years. Mean kidney length, parenchymal thickness, ultrasonographic CKD score and median parenchymal echogenicity were found as 96.2 +/- 12.3, 10.97 +/- 2.59 mm, 6.28 +/- 2.52 and 1.0 (0-3.5), respectively. e-GFR was positively correlated with kidney length (r = 0.343, p < 0.001), parenchymal thickness (r = 0.37, p < 0.001) and negatively correlated with CKD score (r = -0.587, p < 0.001) and parenchymal echogenicity (r = -0.683, p < 0.001). Receiver operating characteristic curve analysis for distinction of e-GFR lower than 60 mL/min showed that the ultrasonographic CKD score higher than 4.75 was the best parameter with the sensitivity of 81% and positive predictivity of 92% (AUC, 0.829; 95% CI, 0.74-0.92; p < 0.001). 3
43. Beland MD, Walle NL, Machan JT, Cronan JJ. Renal cortical thickness measured at ultrasound: is it better than renal length as an indicator of renal function in chronic kidney disease? AJR. 2010; 195(2):W146-149. Observational-Dx 25 patients To determine whether there is a relationship between renal cortical thickness or length measured on US and the degree of renal impairment in chronic kidney disease. Mean cortical thickness was 5.9 mm (range, 3.2-11.0 mm). Mean length was 10 cm (7.2-12.4 cm). Mean minimum serum creatinine was 2.1 mg/dL (1.1-6.1 mg/dL). Mean estimated GFR using Cockcroft-Gault was 34.8 mL/min (10.6-99.4 mL/min) and 36 mL/min (8-66 mL/min) using MDRD. There was a statistically significant relationship between estimated GFR and cortical thickness using both Cockcroft-Gault (P<0.0001) and MDRD (P=0.005). There was a statistically significant relationship between Cockcroft-Gault and length (P=0.003) but not between MDRD and length (P=0.08). 2
44. Kidney International. KDIGO Clinical Practice Guideline for Acute Kidney Injury. Suppl Appendices A to F.  Available at: https://kdigo.org/wp-content/uploads/2016/10/KDIGO-AKI-Suppl-Appendices-A-F_March2012.pdf. Review/Other-Dx N/A Supplementary materials regarding KDIGO's Clinical Practice Guideline for Acute Kidney Injury (AKI). The guideline aims to assist practitioners caring for adults and children at risk for or with AKI, including contrast-induced acute kidney injury (CI-AKI). No results stated in abstract. 4
45. Dewulf K, Abraham N, Lamb LE, et al. Addressing challenges in underactive bladder: recommendations and insights from the Congress on Underactive Bladder (CURE-UAB). [Review]. Int Urol Nephrol. 49(5):777-785, 2017 May. Review/Other-Dx N/A To define underactive bladder (UAB) and its phenotype, define detrusor underactivity (DU) and create a subtyping of DU, evaluate existing animal models for DU, and lastly to establish research priorities for UAB. No results stated in abstract. 4
46. Veenboer PW, Bosch JL, van Asbeck FW, de Kort LM. Upper and lower urinary tract outcomes in adult myelomeningocele patients: a systematic review. [Review]. PLoS ONE. 7(10):e48399, 2012. Review/Other-Dx 13 articles To systematically summarize the evidence on outcome of urinary tract functioning in adult spina bifida (SB) patients. A total of 13 articles and 5 meeting abstracts on urinary tract status of adult SB patients were found describing a total of 1564 patients with a mean age of 26.1 years (range 3-74 years, with a few patients <18 years). All were retrospective cohort studies with relatively small and heterogeneous samples with inconsistent reporting of outcome; this precluded the pooling of data and meta-analysis. Total continence was achieved in 449/1192 (37.7%; range 8-85%) patients. Neurological level of the lesion and hydrocephalus were associated with incontinence. Renal function was studied in 1128 adult patients. In 290/1128 (25.7%; range 3-81.8%) patients some degree of renal damage was found and end-stage renal disease was seen in 12/958 (1.3%) patients. Detrusor-sphincter dyssynergy and detrusor-overactivity acted as adverse prognostic factors for the development of renal damage. 4
47. Dray EV, Cameron AP. Identifying Patients with High-Risk Neurogenic Bladder: Beyond Detrusor Leak Point Pressure. [Review]. Urol Clin North Am. 44(3):441-452, 2017 Aug. Observational-Dx N/A To discuss the impact of specific neurologic diseases on the urinary tract, examine the risks inherent to each, and determine strategies for screening, prevention, and treatment of these complications. No results stated in abstract. 4
48. Groen J, Pannek J, Castro Diaz D, et al. Summary of European Association of Urology (EAU) Guidelines on Neuro-Urology. Eur Urol. 69(2):324-33, 2016 Feb. Review/Other-Dx N/A To provide a summary of the 2015 updated European Association of Urology (EAU) Guidelines on Neuro-Urology. No results stated in abstract. 4
49. Panicker JN, Fowler CJ, Kessler TM. Lower urinary tract dysfunction in the neurological patient: clinical assessment and management. [Review]. Lancet neurol.. 14(7):720-32, 2015 Jul. Review/Other-Dx N/A To discuss clinical assessment and management of lower urinary tract dysfunction in the neurological patient. No results stated in abstract. 4
50. Liao L.. Evaluation and Management of Neurogenic Bladder: What Is New in China?. [Review]. Int. j. mol. sci.. 16(8):18580-600, 2015 Aug 10. Review/Other-Dx N/A To review new work and findings on the diagnosis and management of neurogenic bladder (NB) or neurogenic lower urinary tract dysfunction (NB/NLUTD) in China as well as on recent efforts to treat this disease. No results stated in abstract. 4
51. Olandoski KP, Koch V, Trigo-Rocha FE. Renal function in children with congenital neurogenic bladder. Clinics. 66(2):189-95, 2011. Observational-Tx 58 patients To analyze the evolution of renal function in patients with congenital neurogenic bladder. The mean age at presentation was 4.2 ± 3.5 years. Myelomeningocele was the most frequent etiology (71.4%). Recurrent urinary tract infection was the reason for referral in 82.8% of the patients. Recurrent urinary tract infections were diagnosed in 84.5% of the patients initially; 83.7% of those patients experienced improvement during follow-up. The initial mean glomerular filtration rate was 146.7 ± 70.1 mL/1.73 m2/min, and the final mean was 193.6 ± 93.6 mL/1.73 m2/min, p ?=? 0.0004. Microalbuminuria was diagnosed in 54.1% of the patients initially and in 69% in the final evaluation. Metabolic acidosis was present in 19% of the patients initially and in 32.8% in the final assessment. 2
52. Veenboer PW, Hobbelink MG, Ruud Bosch JL, et al. Diagnostic accuracy of Tc-99m DMSA scintigraphy and renal ultrasonography for detecting renal scarring and relative function in patients with spinal dysraphism. Neurourol Urodyn. 34(6):513-8, 2015 Aug. Observational-Dx 122 patients To study additional benefits of performing Tc-99m dimercaptosuccinic acid (Tc-99m-DMSA) scintigraphy as part of the follow-up of adults with spinal dysraphism (SD), compared with ultrasonography, with regard to finding renal scarring and difference in split renal function. In total, 122 patients (with 242 renal units) underwent both renal scintigraphy and ultrasonography. More scars were seen on DMSA scintigraphy than on ultrasonography: 45.9% vs. 10.3% of renal units; P?<?0.001. Renal scarring seen on DMSA was associated with the presence of hypertension (P?=?0.049) whereas scarring seen on ultrasonography was not (P?=?0.10). If ultrasonography was difficult to interpret, many more scars were missed on ultrasonography (78.9%) compared with easily interpretable ultrasonographic images (30.6%; P?<?0.001). 3
53. Amarenco G, Sheikh Ismael S, Chesnel C, Charlanes A, LE Breton F. Diagnosis and clinical evaluation of neurogenic bladder. [Review]. Eur J Phys Rehabil Med. 53(6):975-980, 2017 Dec. Review/Other-Dx N/A To present an overview of diagnosis and evaluation of neurogenic bladder with a special focus on urodynamic tests. Overactive bladder, with high detrusor pressure associated with detrusor sphincter dyssynergia, can lead to severe complications with renal failure, upper urinary tract dilatation and infectious complications. Underactive bladder with voiding dysfunction and urinary retention, is also a risk factor of urological alterations. 4
54. Pannek J, Bartel P, Gocking K, Frotzler A. Clinical usefulness of ultrasound assessment of detrusor wall thickness in patients with neurogenic lower urinary tract dysfunction due to spinal cord injury: urodynamics made easy?. World J Urol. 31(3):659-64, 2013 Jun. Observational-Dx 60 patients To evaluate the clinical usefulness of sonographic measurement of detrusor wall thickness (DWT) for the prediction of risk factors in patients with neurogenic lower urinary tract dysfunction (NLUTD) due to spinal cord injury (SCI). Urodynamic results were favorable in 48 patients and unfavorable in 12 patients. A DWT of 0.97 mm or less can safely (sensitivity 91.7 %, specificity 63.0 %) be used as a cutoff point for the absence of risk factors for renal damage. 4
55. Cameron AP, Rodriguez GM, Schomer KG. Systematic review of urological followup after spinal cord injury. [Review]. J Urol. 187(2):391-7, 2012 Feb. Review/Other-Dx 12 articles To review the literature to evaluate evidence of urological screening in individuals after spinal cord injury. A total of 12 articles evaluated urinary tract infection screening. Patient reported symptoms used to predict urinary tract infection yielded mixed results and urine dipstick testing had the same accuracy as microscopy. Routine urine culture was unnecessary in healthy, asymptomatic individuals with normal urinalysis. Urodynamics probably must be done periodically (6 articles) but there was no information on frequency. In 11 articles ultrasound was recommended as a useful, noninvasive and possibly cost-effective screening method. Renal scan was a good method for further testing, especially if ultrasound was positive (11 articles). Evidence was sufficient (11 articles) to recommend ultrasound of the urinary tract to detect urinary tract stones with good sensitivity but not plain x-ray of the kidneys, ureters and bladder (2 articles). There was insufficient evidence to recommend urine markers or cytology for bladder cancer screening (9 articles). 4
56. Adriaansen JJE, van Asbeck FWA, Bongers-Janssen HMH, et al. Description of Urological Surveillance and Urologic Ultrasonography Outcomes in a Cohort of Individuals with Long-Term Spinal Cord Injury. Top Spinal Cord Inj Rehabil. 23(1):78-87, 2017. Observational-Dx 282 participants To describe urological surveillance in individuals with long-term spinal cord injury (SCI) and to determine factors associated with urologic ultrasonography (UU) outcome. Median time since injury (TSI) was 22.0 years. Overall, 39% of the 282 participants did not have routine urological checkups and 33% never had a urodynamic study performed. UU data (N = 243) revealed dilatation of the upper urinary tract (UUT) in 4.5% of the participants and urinary stones in 5.7%. Abnormal UU outcome was associated with increasing TSI, nontraumatic SCI, and previous surgical bladder or UUT stone removal. UU outcome was not associated with routine urological checkups or type of bladder-emptying method. 4
57. American College of Radiology. ACR Appropriateness Criteria® Radiation Dose Assessment Introduction. Available at: https://www.acr.org/-/media/ACR/Files/Appropriateness-Criteria/RadiationDoseAssessmentIntro.pdf. Review/Other-Dx N/A To provide evidence-based guidelines on exposure of patients to ionizing radiation. No abstract available. 4
No of Rows: 57