why we look for hydronephrosis

28 Aug

one quick abstract review on the utility of hydro(nephrosis) in a suspected kidney stone patient:

 

Study by Goetz & Lotterman: 

  • retrospective study, ED patients who got a bedside renal ultrasound and had a stone on non-con CT
  • 177 ultrasounds
    • patients with none or mild hydronephrosis (72.9%)
    • rest were moderate to severe hydro

 

  • no or mild hydro: 12.4% with ureteral stone > 5 mm 
  • moderate or severe hydro:  35.4% with ureteral stone > 5 mm 

 

  • negative predictive value of 0.876 (with no or mild hydro)

 

THEIR CONCLUSION:

“Patients with less severe hydronephrosis were less likely to have larger ureteral calculi.”

 

BOTTOM LINE:

no-to-little hydro doesn’t rule out other badness in your differential, but if you’re only worried about a kidney stone, minimal hydro is less likely to mean a big (>5mm) stone.  

moderate to severe hydro, might be big enough that it might need some help from urology.

 

References: articlepicture

 

 

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