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CC BY-NC-ND 4.0 · Indian J Radiol Imaging 2022; 32(04): 601-606
DOI: 10.1055/s-0042-1757117
Case Report

Contribution of Serial Focused High-Resolution Renal Ultrasound in the Management of a Neonate in Acute Renal Failure

Rajesh Gothi
1   Department of Radiodiagnosis, Holy Family Hospital, New Delhi, India
,
Dinesh Raj
2   Department of Pediatrics, Holy Family Hospital, New Delhi, India
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Abstract

Most newborns begin urinating within 24hours of life, and almost always by 48hours. Rarely, some of them are anuric beyond 24hours, thereby causing concern to parents and treating doctors. We report the case of a newborn who presented with anuria till 48hours after birth. High-resolution ultrasound examination, focusing on the renal medulla, demonstrated increased echogenicity at the tip of the pyramids. This was attributed to slow clearance of urinary sediment deposited there, which was causing obstruction to the urinary outflow. On monitoring serially over the next few days, the echogenic sludge was observed being slowly eliminated leading thereby to improvement in the urinary output. High-resolution ultrasound focusing on the renal pyramids played an important role in the observation and management of this transient event unfolding, in the urinary tract.

Keywords

pyramids - echogenicity - anuria - renal medulla - echogenic sludge

If the manuscript was presented as part at a meeting

No.




Publication History

Article published online:
19 September 2022

© 2022. Indian Radiological Association. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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  • References

  • 1 Ring E, Fotter R. The Newborn with Oligoanuria. In: Fotter R. ed. Pediatric Uroradiology. 2nd ed.. Graz: Springer; 2008: 421-430
    Google Scholar
  • 2 Daneman A, Navarro OM, Somers GR, Mohanta A, Jarrín JR, Traubici J. Renal pyramids: focused sonography of normal and pathologic processes. Radiographics 2010; 30 (05) 1287-1307
    CrossrefPubMedGoogle Scholar
  • 3 Aggarwal R, Deorari A, Paul VK. Fluid and electrolyte management in term and preterm neonates. Accessed February 25, 2022 at: https://newbornwhocc.org/pdf/fluid_electrolytes_bablance.pdf
    Google Scholar
  • 4 Hricak H, Slovis TL, Callen CW, Callen PW, Romanski RN. Neonatal kidneys: sonographic anatomic correlation. Radiology 1983; 147 (03) 699-702
    CrossrefPubMedGoogle Scholar
  • 5 Siegel MJ. Urinary tract. In: Siegel MJ. ed. Pediatric Sonography. 3rd ed.. Philadelphia: Lippincott Williams & Wilkins; 2002: 385-473
    Google Scholar
  • 6 Haller JO, Berdon WE, Friedman AP. Increased renal cortical echogenicity: a normal finding in neonates and infants. Radiology 1982; 142 (01) 173-174
    CrossrefPubMedGoogle Scholar
  • 7 Makhoul IR, Soudack M, Smolkin T. et al. Neonatal transient renal failure with renal medullary hyperechogenicity: clinical and laboratory features. Pediatr Nephrol 2005; 20 (07) 904-909
    CrossrefPubMedGoogle Scholar
  • 8 Nada A, Bonachea EM, Askenazi DJ. Acute kidney injury in the fetus and neonate. Semin Fetal Neonatal Med 2017; 22 (02) 90-97
    CrossrefPubMedGoogle Scholar
  • 9 Khoory BJ, Andreis IA, Vino L, Fanos V. Transient hyperechogenicity of the renal medullary pyramids: incidence in the healthy term newborn. Am J Perinatol 1999; 16 (09) 463-468
    Article in Thieme ConnectPubMedGoogle Scholar
  • 10 Riebel TW, Abraham K, Wartner R, Müller R. Transient renal medullary hyperechogenicity in ultrasound studies of neonates: is it a normal phenomenon and what are the causes?. J Clin Ultrasound 1993; 21 (01) 25-31
    CrossrefPubMedGoogle Scholar
  • 11 Nakamura M, Yokota K, Chen C. et al. Hyperechoic renal papillae as a physiological finding in neonates. Clin Radiol 1999; 54 (04) 233-236
    CrossrefPubMedGoogle Scholar
  • 12 Berman LH, Stringer DA, St Onge O, Daneman A, Whyte H. An assessment of sonography in the diagnosis and management of neonatal renal candidiasis. Clin Radiol 1989; 40 (06) 577-581
    CrossrefPubMedGoogle Scholar
  • 13 Hemachandar R, Boopathy V. Transient renal medullary hyperechogenicity in a term neonate. BMJ Case Rep 2015; 2015: bcr2015211285
    CrossrefPubMedGoogle Scholar
  • 14 Walker TM, Serjeant GR. Increased renal reflectivity in sickle cell disease: prevalence and characteristics. Clin Radiol 1995; 50 (08) 566-569
    CrossrefPubMedGoogle Scholar
  • 15 Chavhan G, Daneman A, Moineddin R, Lim R, Langlois V, Traubici J. Renal pyramid echogenicity in ureteropelvic junction obstruction: correlation between altered echogenicity and differential renal function. Pediatr Radiol 2008; 38 (10) 1068-1073
    CrossrefPubMedGoogle Scholar