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Invited Commentary
November 22, 2010

Curbing the Use of Ultrasonography in the Diagnosis of Acute Kidney Injury: Penny Wise or Pound Foolish?Comment on “Renal Ultrasonography in the Evaluation of Acute Kidney Injury”

Arch Intern Med. 2010;170(21):1907-1908. doi:10.1001/archinternmed.2010.411

Acute kidney injury is a common complication in hospitalized patients, occurring in approximately 10% of hospitalizations,1,2 and the incidence of AKI appears to be on the rise.3,4 Although the most common cause of hospital-acquired AKI is acute tubular necrosis,5 physicians frequently rule out urinary tract obstruction as the underlying cause of AKI using ultrasonography. While renal ultrasonography is a safe and noninvasive test, it is not without cost. Moreover, since obstruction is a relatively uncommon cause of hospital-acquired AKI, the majority of ultrasonography results obtained are negative. Therefore, it is likely that in at least a subset of patients with AKI, ultrasonography has limited utility and may not be cost-effective.

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