More frequent measurement of serum creatinine will detect the more rapid deterioration of AKI. The imaging workup is similar to patients with AKI. Arteriography Kidney Arteriography is reserved for intervention rather than for the initial diagnosis of renal failure. Renal revascularization may be considered in a very select group of patients with AKI. There is no relevant literature regarding the use of arteriography in the evaluation of renal failure of unknown duration. CT Abdomen and Pelvis Unenhanced CT of the abdomen and pelvis is useful for characterization of US-detected hydronephrosis by determining level and cause of obstruction. CT is the most sensitive modality for urinary tract calculi and more sensitive than US for retroperitoneal pathology [15]. Although CT can determine whether there is hydronephrosis and measure renal size/volume, it is generally not considered a first-line imaging modality [16]. CT may be considered if US is not feasible or is nondiagnostic because body habitus. There is no relevant literature regarding the use of CT abdomen and pelvis without and with IV contrast in the evaluation of renal failure of unknown duration. Iodinated contrast may be administered to patients established on dialysis without residual renal function. However, CT with IV contrast is not appropriate for the diagnosis of and determination of the cause of kidney failure. CT Abdomen There is no relevant literature regarding the use of CT abdomen in the initial evaluation of renal failure of unknown duration. CTA Abdomen and Pelvis Contrast-enhanced CTA abdomen and pelvis is very rarely indicated in these patients, given the potential nephrotoxicity. The risk-benefit ratio should be carefully evaluated if CTA is necessary to diagnose vascular thrombosis or stenosis. The lowest dose of contrast needed for a diagnostic study should be used and supplemented with adequate volume expansion [9].
Renal Failure. More frequent measurement of serum creatinine will detect the more rapid deterioration of AKI. The imaging workup is similar to patients with AKI. Arteriography Kidney Arteriography is reserved for intervention rather than for the initial diagnosis of renal failure. Renal revascularization may be considered in a very select group of patients with AKI. There is no relevant literature regarding the use of arteriography in the evaluation of renal failure of unknown duration. CT Abdomen and Pelvis Unenhanced CT of the abdomen and pelvis is useful for characterization of US-detected hydronephrosis by determining level and cause of obstruction. CT is the most sensitive modality for urinary tract calculi and more sensitive than US for retroperitoneal pathology [15]. Although CT can determine whether there is hydronephrosis and measure renal size/volume, it is generally not considered a first-line imaging modality [16]. CT may be considered if US is not feasible or is nondiagnostic because body habitus. There is no relevant literature regarding the use of CT abdomen and pelvis without and with IV contrast in the evaluation of renal failure of unknown duration. Iodinated contrast may be administered to patients established on dialysis without residual renal function. However, CT with IV contrast is not appropriate for the diagnosis of and determination of the cause of kidney failure. CT Abdomen There is no relevant literature regarding the use of CT abdomen in the initial evaluation of renal failure of unknown duration. CTA Abdomen and Pelvis Contrast-enhanced CTA abdomen and pelvis is very rarely indicated in these patients, given the potential nephrotoxicity. The risk-benefit ratio should be carefully evaluated if CTA is necessary to diagnose vascular thrombosis or stenosis. The lowest dose of contrast needed for a diagnostic study should be used and supplemented with adequate volume expansion [9].