Ultrasound diagnosis of kidneys preparation for examination and interpretation of results

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Modern medicine has a considerable number of diagnostic tools for diseases of the urinary system, and the key among them is ultrasound of the kidneys.

An ultrasound examination is a safe technique and can be prescribed repeatedly as needed. Diagnostics does not cause painful sensations and other inconveniences.

Ultrasound is used not only in the presence of direct complaints related to kidney pathology, but also as a preventive or screening study.

What is ultrasound

Ultrasonic waves are not perceived by human hearing, but are captured by special equipment. In ultrasound diagnostics of kidneys and other organs, the principle of varying degrees of reflection of ultrasound waves from different tissues of the body is used.

So, formations that are close in structure to bone tissue will reflect waves well and can be called hyperechoic.

Conversely, a hypoechoic picture is given by structures that reflect poorly ultrasound and are similar in density to soft tissues. It is important to note that reflection occurs at the border of formations of different densities, therefore these terms are always used in relation to the surrounding tissues.

With the help of ultrasound examination, at the present stage, it is possible to obtain both two-dimensional and three-dimensional images of an organ, as well as to assess its blood supply.

Indications for the procedure

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The attending physician gives the conclusion about the need for a particular patient to undergo an ultrasound of the kidneys. This is determined by the presence of certain indications associated in most cases with pathologies of the genitourinary system. The appointment of an ultrasound scan is carried out for diagnostic purposes, to obtain more detailed information about the state of the organ responsible for the formation of urine.

An indication for the procedure may be the presence of the following symptoms, indicating the development of pathological processes in the kidneys:

  • lumbar pain
  • painful urination, increased urge,
  • swelling, mainly in the morning,
  • puffiness of the face
  • an admixture of pus or blood and urine, a change in its color, volume,
  • painful sensations in the side, abdomen,
  • the presence of a lower back injury.

A referral for an ultrasound examination can be prescribed at a certain frequency by a nephrologist if the patient is observed for various chronic pathologies. These include the following diseases of the kidneys and other organs:

  • inflammatory diseases of the urinary system,
  • cysts, tumors, kidney abnormalities,
  • urolithiasis disease,
  • renal failure
  • diabetes,
  • persistent hypertension.

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Also, instrumental diagnostics of kidney diseases is often prescribed when changes are detected in the general analysis of urine, which in the initial stages may be the only sign of the disease.

Systematic ultrasound is indicated for conditions such as transplantation of this organ, pregnancy. The study is prescribed for medical examinations and mass screenings.

Preparing for a kidney ultrasound

Preparing a patient for an ultrasound of the kidneys consists of simple, but necessary actions, the purpose of which is to maximize the information content of the study. They can be represented by the following algorithm:

  • If the patient has a tendency to flatulence in the intestines, three days before the procedure, he is advised to follow a special diet before ultrasound of the kidneys. It includes not only a certain diet, but also, if necessary, the intake of so-called carminative drugs that reduce the formation of gases, or antifoams.
  • In some cases, before preparing for an ultrasound examination, adults can be prescribed a cleansing enema the night before and in the morning.
  • On the day of the examination, an hour before the procedure, it is important to drink 2-4 glasses of water – the bladder should be as full as possible by the time of the procedure itself. It is important to note that the liquid must be non-carbonated. Water must be drunk to improve visualization of the organ, primarily the bladder.
  • If you cannot wait until the appointed time of the study, and the question arises of how not to disrupt the preparation for ultrasound of the kidneys, it is allowed to empty the bladder, and then immediately drink another small amount of liquid.
  • You should inquire in advance about the provision of the ultrasound room, where the procedure will be performed, with disposable towels and diapers, which are needed to wipe the gel from the body after the procedure and put it under the patient on the couch, and, if necessary, bring your kit.
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If we talk specifically about the fact that you cannot eat for several days in preparation for an ultrasound, then these are the following products: rye bread, fresh fruits and vegetables, especially legumes, dairy products, sweet, fatty and fried, all kinds of smoked meats.

Questions about how to prepare for a particular patient, whether it is possible to eat before an ultrasound of the kidneys, how much water to drink, what regimen to follow and what to take with you should be clarified with the attending physician.

How is kidney ultrasound performed?

For a successful study, it is important for a patient to remember that queues line up in the ultrasound diagnostic room, and all scheduled examinations are carried out by appointment at a strictly regulated time. The kidney ultrasound procedure itself lasts, as a rule, no more than half an hour and includes the following stages:

  • the patient enters the office, after which it is standard practice to close the door with a key – which contributes to the concentration of the doctor and the patient’s calmness,
  • the patient is asked to free the lumbar region and abdomen from clothes, lie down on a couch, where a clean diaper is placed beforehand,
  • the study is carried out in the position of the patient on the side and back to maximize the quality and increase the visualization area,
  • the sensor of the device is tightly pressed to the skin, having previously processed the field of work with a special gel,
  • the kidney ultrasound procedure is painless, the patient can only feel the cold from the touch of the device,
  • as a rule, a separate study of the kidneys is not carried out – if a procedure has already been prescribed, the entire urinary system is examined, starting with the bladder, going to the ureters and higher,
  • an important component of a comprehensive examination is an assessment of the state of renal blood flow – vascular Doppler ultrasonography,
  • after the procedure, the patient is asked to stand up and use a disposable towel in order to remove the excess gel from the skin.

There may be variations on the question of how kidney ultrasound is done in different medical institutions, but the main points are mandatory, since the purpose of the study is always the same – to assess the state of organ tissues and their ability to perform their functions.

Ultrasound of the kidneys during pregnancy

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During pregnancy, a woman’s body is under tremendous stress. One of the most frequent complications in this case is the pathology of the urinary organs, which dictates the need to monitor the state of the urinary system throughout pregnancy.

Since during this period the range of safe research methods is sharply limited, ultrasound diagnostics comes to the fore, along with laboratory analysis of urine.

Preparation for ultrasound of the kidneys in this case does not differ much from the standard rules, however, each pregnant woman needs to check with her gynecologist in the antenatal clinic how in her particular case it is necessary to prepare for the procedure.

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Kidney ultrasound in children

There are no direct restrictions on ultrasound examination in babies and adolescents of different ages, so the procedure can be prescribed even for children under one year old, depending on the availability of indications.

Preparing a child for an ultrasound of the kidneys requires close attention from the parents, but in general it does not differ from that of an adult.

Unfortunately, the trend towards a decrease in the level of health of children leads to the fact that the organs of the urinary system can suffer even in very young children. Timely ultrasound examination is necessary, as it is known: the earlier the pathology is detected, the more favorable the prognosis of its treatment.

Explanation of results

The conclusion about the data obtained during the ultrasound scan is given by the ultrasound diagnostic doctor. This is a rather complex procedure, and no one should be involved in the interpretation of the results, except for a highly professional specialist.

On ultrasound, the kidneys are assessed according to the following characteristics:

  • quantity – with congenital anomalies, there may be only one or the presence of an additional organ,
  • mobility – each kidney, at normal rates, is securely fixed and motionless, only during breathing is some displacement possible, which does not reach two centimeters,
  • position – normally, each kidney is located in the lumbar region on the sides of the spine, the right one is at the level of the XII thoracic vertebra, the left one is XI,
  • in shape, the organ should be bean-shaped, in size – up to 120 mm in length, in structure – homogeneous,
  • normally, each kidney has smooth and clear contours.

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Ultrasound examination can clearly show changes in these parameters. If the size and shape of the organ is changed, we should talk about spliced, or horseshoe-shaped kidneys, and deformities in the form of the letters L and S can also be observed.

In case of violation of fixation, the organ begins to “wander”. If their location is disrupted relative to each other or the spinal column, we are talking about nephroptosis.

The organ can grow in size (hypertrophy) or decrease (hypoplasia). The change in the tissue itself is evidenced by the heterogeneity of the structure of the kidney. Also, from the common pathological signs, there can be observed the presence of air in the renal-pelvic system, as well as the presence of stones or sand in the lumen of the urinary tract.

However, this is only a general idea of ​​the possibilities of ultrasound diagnostics.

For a healthy person, this study is shown to take place no more than once a year, in the presence of certain pathologies it should be regular, since ultrasound is a reliable way to track the dynamics of the course of the disease, not to miss its progression and the occurrence of acute conditions, such as, for example, obstruction of the ureter with urolithiasis.

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Svetlana Borszavich

General practitioner, cardiologist, with active work in therapy, gastroenterology, cardiology, rheumatology, immunology with allergology.
Fluent in general clinical methods for the diagnosis and treatment of heart disease, as well as electrocardiography, echocardiography, monitoring of cholera on an ECG and daily monitoring of blood pressure.
The treatment complex developed by the author significantly helps with cerebrovascular injuries and metabolic disorders in the brain and vascular diseases: hypertension and complications caused by diabetes.
The author is a member of the European Society of Therapists, a regular participant in scientific conferences and congresses in the field of cardiology and general medicine. She has repeatedly participated in a research program at a private university in Japan in the field of reconstructive medicine.