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Kidney Week

Abstract: SA-PO549

Comparison of Effectiveness of Renal Ultrasonography in the Work-up of AKI Before and After the Introduction of a Risk Stratification Model

Session Information

Category: Acute Kidney Injury

  • 102 AKI: Clinical, Outcomes, and Trials

Authors

  • Gutman, Anna Sheina, Northwell Health, Brooklyn, New York, United States
  • Wiesel, Shimshon, Staten Island University Hospital, Staten Island, New York, United States
  • Narula, Naureen, Staten Island University Hospital, Staten Island, New York, United States
  • Fuca, Nicholas, Staten Island University Hospital, Staten Island, New York, United States
  • Leifer, Lazer, SIUH, Brooklyn, New York, United States
  • El Sayegh, Suzanne E., Staten Island University Hospital, Staten Island, New York, United States
Background

In 2010, Licurse et al, created the Licurse Model for risk stratification of patients according to the probability of having an obstructive cause of acute kidney injury (AKI). The researchers suggested that renal ultrasonography (RUS) findings do not change the management of patients with AKI in most cases. They found that performing RUS only in patients with a higher pre-test probability of urinary tract obstruction conserves resources. They constructed a model consisting of seven variables, which stratified patients with AKI into low, medium, and high risk of obstructive cause of AKI.

Methods

We conducted a retrospective chart review project looking at a total of 482 patient charts, who had RUS performed in the work up of AKI from Jan. 2012 to Mar. 2018 at Staten Island University Hospital. In the months of Oct. 2017 through Dec. 2017 we performed an intervention, which consisted of educating the house staff regarding the appropriate use of a RUS in the work up of AKI. We compared the percentage of patients who met the criteria of the Licurse Model for ordering RUS, had positive findings on RUS, and had a change in clinical management based on the RUS findings before and after our intervention.

Results

We found that the percentage of patients who had RUS in the work up of AKI was 49.9% before the intervention, compared to 49.3% after the intervention, P-value 0.936. The percentage of patients who had a change in clinical management based on RUS findings was 7.23% before the intervention, and 6.17% after the intervention, P-value 0.734.

Conclusion

Our results show that there was no improvement in the effectiveness of RUS for the work up of AKI after the intervention at our facility. Our intervention consisted of educating the resident physicians, and a small number of the attending physicians about the proper use of RUS for the work up of AKI.