In order for the procedure of ultrasound scanning of the kidneys to give the most reliable results, you need to know what preparation is being made for ultrasound scanning of the kidneys in women and men. What algorithm will help a person to properly prepare for the procedure, what rules of nutrition and cleansing should he follow, and what are the features of preparing for the study when conducting an ultrasound of the kidneys in a child?
General principles of training for men and women
In order for the patient’s preparation for the examination to be as effective as possible, you must strictly follow the rules and recommendations of the doctor who is conducting the treatment. The general principles of preparing for the survey are as follows:
- Free the intestines from gas accumulations. Ultrasound waves give distorted results if gas inclusions are present in the colon, so special attention must be paid to this issue.
- Before the procedure, 3-5 days before, you need to go on a diet and follow a gentle diet, excluding from the menu gas-forming foods, fatty and spicy foods, milk, sweets, baked goods, vegetables and fruits, which lead to indigestion and the formation of unnecessary gases. During the diet, drink enough liquid, preferably regular clean drinking water.
- In 3-5 days you need to start cleaning the intestines of old deposits and feces. It is recommended to drink activated carbon, which will cleanse the body of toxic inclusions, then take mild laxatives as prescribed by the doctor.
Patients are interested in whether they can drink and eat on the day of the study? The diet before a kidney ultrasound excludes a heavy dinner the day before; however, on the day of diagnosis you can eat a light breakfast, drinking is not limited and you can take it with you to the procedure. But when, together with an ultrasound of the kidneys, other abdominal organs, for example, the bladder, are also subject to examination, then it is advisable to conduct the study on an empty stomach.
Medication preparation
In some cases, the doctor prescribes medications before the procedure. If the patient has problems with gas formation, then medicinal preparatory procedures for ultrasound of the kidneys and bladder include taking medications that will help reduce the process of gas formation and ease the load on the intestines. Often the doctor advises using a medicine such as Espumisan. The medicine is well tolerated by adults and children; follow the dosage according to the doctor’s recommendations. Enterosorbents are also indicated in preparation for the study; these are drugs such as activated black or white carbon, Smecta, Enterosorb. The medicine should be taken in the evening before the ultrasound and in the morning, a couple of hours before the diagnosis.
For problems with digestion, patients are prescribed enzyme medications that regulate the production of a certain type of enzyme, as a result of which food is fully digested without the formation of stagnant processes and abundant formation of gases. This group includes drugs such as Mezim Forte, Festal and others. There are cases when a patient may take medications that can affect the results of the study and significantly distort them. Therefore, when taking such drugs, you need to warn your doctor, who will then decide the advisability of their further use.
Colon cleansing before ultrasound procedure
In the process of preparing for the kidney ultrasound procedure, cleansing procedures using enemas are not a mandatory event. But if you have problems with the functioning of the gastrointestinal tract and a tendency to constipation and increased formation of gases, you cannot do without enemas with a cleansing solution. Cleaning is done 12 hours before diagnosis. When everything is in order with the intestines and stomach, the patient has regular bowel movements and does not suffer from constipation, cleansing can be carried out with mild laxatives based on herbal ingredients. In this case, a medicine based on the herb senna is perfect. You can also use artificial medications, but before using them, it is recommended to consult with your doctor. Products based on lactulose are contraindicated in preparation for an ultrasound of the kidneys and bladder, as they provoke strong gas formation.
Patient's diet
Is it possible to eat all foods?
Before an ultrasound, you can eat foods that do not form gases in the abdominal organs. To successfully undergo ultrasound diagnostics, you must also follow a therapeutic diet, which will help you prepare properly and get the most accurate results. It is recommended to eat light foods that will not put too much strain on the stomach and intestines and will help eliminate the excessive formation of gases. These are primarily porridges cooked in water with the addition of a small amount of oil. Buckwheat, rice and oatmeal porridge will be useful. You can serve them with boiled chicken breast and fresh vegetable salad. Boiled eggs, feta cheese, low-fat milk, herbal teas, compotes, juices and fruit drinks are suitable.
What should you not eat before an ultrasound?
Products such as brown bread, fatty meats, smoked meats, white cabbage, black coffee or tea are contraindicated, as they contribute to the excessive release of gases, which is unacceptable with this type of diagnosis. Not You are allowed to drink alcoholic beverages, beer, soda, you should also avoid smoking. You also need to remove milk chocolate, sweets, sweet pastries and muffins from the menu. A more accurate list is agreed upon with the doctor, who takes into account the patient’s health status and, accordingly, adjusts the dietary menu.
Is food allowed before diagnosis and what to drink?
When a patient is sent for an ultrasound of the kidneys, then 2-3 hours before the procedure you need to completely stop eating any food, that is, the study needs to be carried out on an empty stomach. At the same time, drinking before diagnosis is not contraindicated, but the liquid should not be too hot or cold, drink is consumed without gases, dyes and preservatives. If you need to go for a kidney ultrasound in the afternoon, the patient can make himself a light breakfast and the same lunch, following the doctor’s dietary recommendations.
Preparation for ultrasound of pregnant women
Conducting an ultrasound of the kidneys for pregnant women does not require special preparation, but a number of rules must be followed. It is easy for pregnant women to prepare for the diagnosis. It is not contraindicated to undergo an ultrasound scan during this period; the procedure is performed at the very beginning of pregnancy and until the birth of the child according to indications. Ultrasound of kidney vessels and tissues is carried out if the development of pathological processes is suspected and during exacerbation of chronic diseases, which often bother pregnant women.
You also need to prepare correctly for an ultrasound of a pregnant woman. 2-3 days before the test, you need to give up food that provokes fermentation and stagnation in the digestive organs. It is recommended to maintain a drinking regime; on the day of diagnosis, you should not refuse fluids, but limit food intake 2.5-3 hours before the ultrasound diagnosis. Enemas and other cleansing procedures should be carried out according to the doctor’s indications; in some pathologies of the genitourinary system, such manipulations can harm the health of the pregnant woman, so you must strictly follow the doctor’s advice and inform him about changes in your health.
As a routine examination, ultrasound is used in the postpartum period to identify the remains of the placenta, as well as for the early diagnosis of endometritis. As a rule, an ultrasound of the uterus is performed on all women on the third day after childbirth.
In gynecology, ultrasound is performed to identify various anomalies in the development of the reproductive system and space-occupying formations ( cyst, fibroid). For this purpose, both the transabdominal and transvaginal methods can be used.
General therapy
All types of ultrasound examination are used in general therapy. The choice of one method or another depends on the area of therapy where ultrasound is used.
Thus, in endocrinology, ultrasound in 2D mode with Doppler ultrasound is most often used. This method allows you to determine not only abnormalities in the structure of the thyroid gland and other glands, but also to evaluate their blood supply. In gastroenterology, transabdominal ultrasound is usually used. With its help, space-occupying formations and developmental anomalies of the liver and pancreas are determined. Ultrasound also reveals changes in the parenchyma of organs, thereby helping to identify chronic pathologies ( pancreatitis, hepatitis).
In nephrology and urology, ultrasound is used to determine pathologies of the genitourinary system. For this, transurethral and transrectal methods are most often used. They help identify developmental abnormalities, space-occupying formations and inflammatory processes.
In cardiology, M-mode ultrasound or echocardiography is used. Using this method, pathologies of the heart valves are diagnosed ( heart failure and stenosis), developmental anomalies ( valve prolapse), as well as inflammatory pathologies ( endocarditis).
General and vascular surgery
Ultrasound is used for the preliminary diagnosis of most acute surgical emergencies ( peritonitis, trauma). For this purpose, the transabdominal method is used as an emergency diagnostic method. In vascular surgery, the Doppler ultrasound method is used. This is one of the ultrasound diagnostic methods that studies the movement of blood through the vessels. The method is used to assess the patency of the veins of the lower extremities, to diagnose thrombosis and atherosclerosis in the vessels of the legs.
Using Doppler ultrasound, the speed of blood flow in the affected vessels, as well as the location of narrowings, is determined. The method is indispensable in the diagnosis of thrombophlebitis, diabetic angiopathy and thrombosis.
Oncology
In oncology, the method of sonoelastography is used to identify various tumor processes. This type of ultrasound helps detect cancer at very early stages of development. Sonoelastography can determine not only the location and size of a tumor formation, but also differentiate it between a benign and a malignant tumor. The method is indispensable in the diagnosis of breast cancer and thyroid cancer, pelvic tumors, including lymph nodes and scrotum.
Neurology
In neurology, ultrasound examination of the brain is used, which is called echoencephalography. The method is used to identify organic brain lesions and displacements of its midline structures. Echoencephalography also evaluates the amount of cerebrospinal fluid and its circulation.
The ultrasound method is used not only to diagnose various pathologies, but also for therapeutic purposes. For example, in dentistry, ultrasound is most often used to clean teeth. Removing tartar using ultrasound is a safer and less traumatic method. In rheumatology, ultrasound waves are used to treat joints. However, the phenomenon of echolocation is used as much as possible in physiotherapy as a treatment.
Normal sizes of kidneys and ureters
The kidneys are paired bean-shaped parenchymal organs that are located in the lumbar region. A ureter emerges from each kidney, which originates from the renal pelvis and opens into the bladder. The renal pelvis, along with the small and large renal calyces, represents the excretory system of the kidney. In them, urine is filtered from the kidney parenchyma, which then goes through the ureters and accumulates in the bladder. In the parenchyma itself, the kidneys secrete the cortex and medulla. In the cortex there are glomeruli, and in the medulla there are tubules that form into the so-called pyramids. Each of these structures gives a certain echogenicity. When performing an ultrasound examination, all anatomical structures of the kidney, their size, and position are examined. Parameters that are examined during an ultrasound of the kidneys:
- quantity;
- mobility;
- position and shape;
- dimensions;
- structure and contours;
- renal collecting system;
- ureters.
Quantity
Usually a person has two kidneys. However, quantity anomalies such as the absence of one kidney may occur ( agenesis) or accessory kidney.Mobility
Normally, the kidney is fixed and does not move. When breathing, its mobility should be no more than 1.5 - 2 cm. With a drooping or so-called wandering kidney, this parameter increases.Position and shape
Normally, the kidneys are located in the lumbar region, on both sides of the spine. The left kidney is located slightly higher than the right. The boundaries of the left kidney are the eleventh vertebra from above and the third lumbar from below. The right kidney is located at the level of the twelfth thoracic and fourth lumbar vertebrae.Sometimes the kidneys are much lower, and then this phenomenon is called nephroptosis. Kidney ( or both kidneys) may be in a completely unusual place, for example, in the pelvis. Also, both kidneys can be on the same side, one is in its place, and the other is slightly lower.
Also, when performing an ultrasound, the doctor pays attention to the shape of the kidney. Typically the bud is bean-shaped. However, such shape anomalies as an S-shaped kidney, an L-shaped kidney, a horseshoe kidney, or fusion of both kidneys may occur.
Dimensions
The size of the kidneys is of great diagnostic importance, since many pathologies are accompanied by a decrease or enlargement of the kidneys.Average kidney sizes:
- length – from 100 to 120 mm;
- width – from 50 to 60 mm;
- thickness – from 40 to 50 mm;
- thickness of the parenchymal layer – from 20 to 25 mm;
- capsule thickness – up to 1.5 mm;
- weight – from 120 to 200 grams
However, a kidney can shrink or enlarge not only due to some pathological process, but also with age. Thus, with age-related changes, a smaller kidney is noted. In this case, there is a decrease in the predominantly parenchymal layer, which can reach up to 10–15 mm ( norm 25 mm) in people over 60 years of age. If a person has one kidney removed and the other takes on the function of both, then it can grow compensatory.
Structure and contours
Normally, the structure of the kidney is heterogeneous; there are areas of low, medium and high density. Areas of low density ( dark color) are the pyramids of the kidneys, while the rest of the parenchyma gives an average echogenic picture ( lighter areas). The kidney capsule gives the maximum echogenicity. On ultrasound it is indicated by the lightest color. In general, the kidney has a structure of medium density, which on ultrasound gives different shades of the gray scale.Any pathological process in the kidney disrupts this structure. Thus, with a spongy kidney, instead of hypo- and hyperechoic areas, multiple tiny cysts are visualized. Compaction of individual structures, for example, the capsule, may be a consequence of inflammation. Foreign bodies ( tumor or stone) give increased echogenicity, which is clearly visualized against the background of the average echogenicity of the kidney. Acute inflammatory processes accompanied by swelling of the renal tissue give a hypoechoic picture ( dark color on ultrasound).
The outer contour of the kidney is smooth and clear. Sometimes, there may be a slight bulging ( humpback kidney), which is also a variant of the norm.
Pyelocaliceal apparatus of the kidneys
Normally, the collecting apparatus of the kidney, which is represented by the calyces and pelvis, is not visualized on ultrasound, that is, it is anechoic. These structures begin to be visualized only in the case of pathology. Dilation of the pelvis most often indicates pyelonephritis or urolithiasis.However, stones may form in place of the pelvis. Then they give a picture of increased echogenicity, and the shape of the stone can follow the contours of the pelvis.
Ureters
The ureter is a paired tubular organ that arises from the kidney and ends in the bladder. The average length of the ureter ranges from 25 to 30 cm, and its diameter is 6 – 9 mm.Shortening or lengthening of the ureters may result from congenital abnormalities. A long ureter can become twisted, causing urine to stagnate in it. The consequence of this is urine infection and the development of infectious processes.
On ultrasound, the ureter is visualized as anechoic ( dark color) tubular formation with hyperechoic ( light color) walls. This is explained by the fact that the ureter is hollow inside and its walls are made of connective tissue. Connective tissue is a dense structure and, similar to the kidney capsule, produces hyperechogenicity.
Ultrasound examination of the ureters also determines their position, shape and number. So, there may be not two, but three ureters. They can be doubled, expanded or twisted. Orifices of the ureters ( where they open into the bladder) can be blocked by valves, as a result of which urine will accumulate in the ureter and overstretch it. All this will lead to their expansion by more than 9 mm.
If a stone passes through the ureter, then against the background of anechoic ( dark) the ureteral cavity appears hyperechoic ( light) oval formation.
Indications for kidney ultrasound
Ultrasound examination of the kidneys and urinary tract is prescribed for the diagnosis of various diseases of the urinary system or other systems, complications of which include kidney damage. Indications for ultrasound examination of the kidneys and urinary tract:
- damage to the kidney parenchyma;
- renal emphysema ( presence of gas in the kidney);
- vascular diseases of the renal circulation;
- cystic kidney diseases;
- kidney injuries and bruises;
- myoglobinuria ( presence of muscle protein myoglobin in urine);
- inflammation of the urinary collecting system;
- stones in the kidneys and urinary tract;
- kidney tumors ( benign, malignant and metastases);
- transplanted kidney.
Ultrasound examination of diseases involving renal parenchyma
During ultrasound examination of the kidneys, the echogenicity of the renal parenchyma is assessed in comparison with the parenchyma of the liver or spleen. The renal parenchyma on ultrasound is visualized as less echogenic than the liver parenchyma.| Pathology | Purpose of ultrasound appointment | Ultrasound signs |
| Acute glomerulonephritis with renal failure |
| At an early stage of the disease, ultrasound does not indicate any deviations from the norm. When swelling of the renal parenchyma appears, an enlarged kidney is visualized on ultrasound. The boundaries of the renal parenchyma become more distinct, and echogenicity increases. The renal pyramids remain hypoechoic - “knocked out pyramids”. |
| Chronic pyelonephritis | Assess the size of the kidney, the presence or absence of hyperechoic structures in it. | The kidneys are reduced in size. The echogenicity of the kidneys may not be changed. |
| Nephrosclerosis | Identify the proliferation of connective tissue in the kidney, and also evaluate its size. | The echogenicity of the parenchyma is increased due to the presence of dense connective tissue. With extensive damage, the kidney is reduced in size. |
| Renal fibrolipomatosis | Exclude various tumor formations and infectious processes. | A large amount of adipose tissue in the renal parenchyma usually increases the echogenicity of the parenchyma. |
| Kidney swelling | Identify the possible cause of edema and exclude cystic formations. | The main ultrasound sign is a decrease in the echogenicity of the parenchyma. The renal pyramids are visible as hypoechoic areas, but can also be anechoic. They are often confused with cysts. The kidney capsule becomes clearer and more pronounced. |
Ultrasound examination for renal emphysema
Renal emphysema may occur as a result of surgical interventions, instrumental manipulations in the genitourinary system, or the formation of fistulas ( connections) with the intestines.Ultrasound examination of kidneys with emphysema reveals echogenic areas from which a shadow path extends.
Ultrasound examination for renal failure
Kidney failure is an umbrella term that means the kidney can no longer do its job. Deficiency can be acute or chronic. However, the causes of renal failure can be very diverse and are not always localized in the kidneys ( for example, diabetes mellitus).Causes of kidney failure:
- acute glomerulonephritis;
- acute tubular necrosis;
- damage to large and small vessels;
- urinary system infections;
- obstruction of the urinary tract;
- diabetes;
- high blood pressure.
| Pathology | Purpose of ultrasound appointment | Ultrasound signs |
| Kidney failure |
| The urinary tract may be dilated. The parenchyma is hypoechoic and sometimes heterogeneous. With obstruction, the dilated renal pelvic apparatus of the kidney and dilated ureters are visualized. The structure of the kidney is heterogeneous, the contours are blurred. |
Ultrasound examination for vascular diseases of the renal circulation
These diseases include lesions of the renal vein and arteries. These may be narrowings ( stenoses), blockage by a blood clot ( thrombosis), as well as violation of the integrity of blood vessels during trauma.| Pathology | Purpose of ultrasound appointment | Ultrasound signs |
| Renal vein thrombosis | The goal of ultrasound examination of blood vessels is the same and boils down primarily to the fact that it is necessary to determine the type and caliber of the affected vessel. At the second stage, it is necessary to detect areas with hemorrhages and infarction of the kidney and assess the extent of the damage. | At the first stage of the disease, ultrasound shows an enlarged kidney with reduced echogenicity along the periphery ( in the cortex). After 1–2 weeks, the periphery becomes echogenic. Sometimes small hypoechoic areas appear due to focal hemorrhages. Doppler ultrasound reveals a decrease or absence of blood flow in the renal vein. If “bypass” venous blood flow develops, the echogenicity returns to normal, but the kidney may decrease in size. |
| Renal artery thrombosis | When one branch of the renal artery is affected, ultrasound shows an echogenic heterogeneous area, which becomes hypoechoic within a few days. If the thrombus is located in the main trunk of the renal artery, then initially the kidney is enlarged in size. With a prolonged absence of blood supply, the kidney atrophies and decreases in size, becoming hypoechoic. The final diagnosis is made based on the results of the Doppler study. Doppler ultrasound reveals a decrease or absence of blood flow in the artery with a thrombus. | |
| Renal artery stenosis | Areas of renal infarction on ultrasound are visualized as hypoechoic triangular areas in the parenchyma. When infarct areas are replaced by connective tissue ( scar), on ultrasound they become hyperechoic. |
Ultrasound examination for cystic kidney diseases
A cyst is a limited collection of fluid. Cysts can be the result of previous diseases, injuries, or infections. But they can also be the result of hereditary abnormalities.| Pathology | Purpose of ultrasound appointment | Ultrasound signs |
| Cyst in the kidney |
| Simple cyst On ultrasound, a simple cyst is visible as a completely echo-negative formation of a round or oval shape with an even contour, but without a pronounced wall. Hydatid cyst |
| Polycystic kidney disease (hereditary pathology) |
| In the initial stages of the disease, the cysts are very small, 0.1–5 millimeters in diameter, and are not detected on ultrasound. However, increased echogenicity of the parenchyma is noticeable due to tissue rupture around the cysts. As the disease progresses, ultrasound visualizes enlarged kidneys with an uneven contour and many echo-negative rounded zones of varying sizes ( from 0.5 to 3 - 4 centimeters or more). |
| Multicystic renal dysplasia |
| Ultrasound shows a unilateral increase in the size of the kidney, with many echo-negative round formations of various diameters. The echogenicity of the renal tissue between cysts is heterogeneous. |
Ultrasound examination for kidney injuries and bruises
The kidneys, due to their retroperitoneal position, fortunately, are rarely injured. However, during injuries, not only the parenchyma of the kidney is damaged, but also its vessels or ureters.| Pathology | Purpose of ultrasound appointment | Ultrasound signs |
| Injury |
| Ultrasound reveals deformation of the normal contour of the kidney with a hypoechoic focus. |
| Hematoma in the kidney (collection of blood) | The accumulation of blood under the renal capsule on ultrasound appears as a slightly pronounced echogenic contour of the kidney. The accumulation of blood in the parenchyma produces a hypoechoic image of varying sizes, depending on the amount of bleeding. If the bleeding does not stop, the hypoechoic area increases in diameter. As the blood begins to clot, the area becomes echogenic. |
|
| Perirenal hematoma | The accumulation of blood in the perinephric space is visualized on ultrasound as an echo-negative structure. As blood clots, this area becomes moderately echogenic. The contour of the kidney does not change. |
Ultrasound examination for myoglobinuria
Myoglobinuria is a condition in which urine becomes reddish-brown in color due to the presence of the myoglobin pigment. The main cause of myoglobinuria is extensive damage and necrosis ( necrosis) muscles. As a result of muscle necrosis, a large amount of muscle protein myoglobin is released into the general bloodstream. When blood is filtered by the kidney, myoglobin is deposited in the kidney tissue. Using ultrasound, you can detect an increase in echogenicity in the renal cortex, where protein accumulates. The structure of the kidney is preserved.Ultrasound examination for inflammation of the urinary collecting system
These pathologies include acute and chronic pyelonephritis ( damage to the renal collecting apparatus), as well as abscesses.| Pathology | Purpose of ultrasound appointment | Ultrasound signs |
| Acute pyelonephritis |
| The kidney is of normal size or slightly enlarged with reduced echogenicity. The collecting system and ureters are dilated. The accumulation of fluid gives them an echo-negative image. |
| Abscess (localized collection of pus) of the kidney | Determination of the shape of the dimensions. Needle biopsy. | Ultrasound visualizes a rounded hypoechoic or anechoic formation with uneven edges. The walls are thick and visualized as hyperechoic. When gas is present, hyperechoic circular areas with shadow tracks are visible against a hypoechoic background. |
| Abscess after kidney removal | Identify the inflammatory process in the renal bed. | The accumulation of pus in the renal bed is visualized as a large echo-negative formation. When an anaerobic infection is attached and air appears on an echo-negative background, hyperechoic round areas with shadow tracks are visible. |
| Forgotten surgical swabs |
| Dense echogenic formations of various shapes. Sometimes linear folds or a woven structure of the fabric are visible. Echogenic inclusions can be found in the collecting system. |
Ultrasound examination for hydronephrosis
Hydronephrosis is a condition characterized by dilation of the urinary storage system ( calyces and pelvis) kidneys. A large accumulation of fluid in this system gives an echo-negative image on ultrasound. The cups are widened and flattened. The pelvis is also dilated, but the ureters are normal. With excessive accumulation of fluid, the kidney parenchyma becomes thinner. The ultrasound image of such a kidney is called a “bag of water”.Ultrasound examination for stones in the kidneys and urinary tract
Kidney stones are difficult to detect using ultrasound. They are most clearly visualized against the background of hypoechoic urine in the dilated urinary collecting ducts. On the monitor, stones are visible as hyperechoic structures of varying sizes ( from 2 – 3 millimeters to the size of the urinary collecting ducts) with a shadow path.Ultrasound examination for kidney tumors
Tumors in the kidneys can be either benign or malignant. Also, tumors from neighboring pelvic organs often metastasize to the kidneys ( bladder, rectum).| Pathology | Purpose of ultrasound appointment | Ultrasound signs |
| Tumor formations in the kidneys |
| Benign tumors Ultrasound reveals round space-occupying formations, echogenic, usually small in size. Malignant tumors In 10 to 20 percent of cases, calcifications are found in tumors - very echogenic peripheral or central areas. As the tumor grows, the space-occupying lesion extends beyond the renal contour. |
| Metastases in the kidneys (more often in lung cancer, melanoma, breast cancer) |
| Ultrasound reveals hypoechoic formations of various sizes and shapes. They can be unilateral or in both kidneys at the same time. Their location is most often in the renal cortex. |
Ultrasound examination of a transplanted kidney
The main purposes of ultrasound examination are:- determining the size, contour and volume of the graft;
- determination of viability;
- detection of transplant rejection;
- identification of complications.
In case of transplant rejection, large echolucent pyramids are visualized on ultrasound. The echogenicity of the central complex decreases until small hypoechoic foci are identified. With focal bleeding and parenchymal infarction, heterogeneous echogenicity appears. With severe edema, ultrasound reveals an increase in the size of the kidney ( by more than 22 percent).
Ultrasound examination detects postoperative urinomas ( urine accumulation), abscesses and lymphoceles ( lymph accumulation). They give a nonspecific picture of echo-negative cavities of a round shape. The final diagnosis is made after a puncture biopsy under ultrasound guidance.
In modern diagnostics, ultrasound examination of the kidneys is prescribed in the presence of various symptoms associated with disruption of the functioning or integrity of the urinary system.
Signs indicating dysfunction or integrity of the urinary system :
- the appearance of pain in the lumbar region, in the kidneys or along the course of the ureters;
- hematuria ( presence of blood in urine);
- increase in kidney/kidney size;
- chronic infections of the genitourinary system;
- various injuries ( penetrating and non-penetrating);
- suspicion of polycystic kidney disease;
- fever of unknown etiology;
- renal failure;
- non-functioning kidney according to the results of urography.
Preparing for an ultrasound of the kidneys
Preparation for ultrasound of the kidneys and ureters includes measures that should provide better visualization of organs during diagnosis. Ultrasound waves travel well through fluids, so the patient's bladder must be full. Ultrasound is interfered with by gases and air, so the intestines must be cleared of gases before the procedure. Preparatory measures before ultrasound of the kidneys:
- diet – for three days before the examination;
- taking medications – for three days before the doctor’s visit;
- microenemas or taking laxatives ( if the patient suffers from constipation) – in the evening, on the eve of the ultrasound;
- drinking fluid to prepare the bladder – an hour before the diagnosis;
- refusal to eat – eight hours before the ultrasound;
- preparing things for a hospital visit.
Diet before ultrasound diagnostics of the kidneys
Three days before an ultrasound examination of the kidneys, you must avoid foods that cause excessive gas formation in the intestines.Foods that should not be consumed when preparing for a kidney ultrasound:
- vegetables - white cabbage, corn, potatoes, onions;
- legumes – beans, peas;
- fruits – apples, cherries, pears, prunes;
- black bread, flour products;
- sugar and confectionery;
- bran;
- starch;
- milk, kefir, cream.
Actions that provoke gas formation:
- eating bell peppers and zucchini that have not undergone heat treatment;
- a hearty dinner including meat, fish, mushrooms, eggs;
- drinking while eating;
- drink plenty of fluids after spices.
Foods that can be eaten in preparation for an ultrasound examination of the kidneys:
- low-fat hard cheese;
- pearl barley, oatmeal, buckwheat;
- boiled rice;
- boiled beef, chicken, rabbit;
- boiled fish;
- boiled eggs ( no more than 1 piece per day).
- yoghurts with enzymes and bifidobacteria;
- mint ( peppery, fragrant, spiky) – consume as a drink;
- cinnamon, ginger – use as spices.
Medication preparation
People who suffer from flatulence ( accumulation of gases in the intestines) before an ultrasound scan of the kidneys, adrenal glands and ureters, it is necessary to take medications that reduce the amount of gases. You should start taking medications two to three days before the procedure.Medicines against flatulence:
Defoamers (drugs that help break up gas bubbles):
- meteospasm.
- carbon based ( activated carbon, carbolong, sorbex);
- silicon based ( enterosgel) – the drug is available in the form of a paste;
- based on lignin ( filtrum).
You can reduce the amount of gas in the intestines with the help of herbal preparations. You need to purchase the products at the pharmacy and use them as an infusion. To make the drink, add hot water to the dry ingredients and leave to steep for an hour. You need to drink 1 glass a day ( 250 milliliters) infusion, taking the remedy before meals.
Herbal preparations that reduce the amount of gas in the intestines:
- fennel ( fruit) – 1 tablespoon per 1 glass ( 250 milliliters) water;
- cumin ( fruit) – half a tablespoon per 1 glass ( 250 milliliters) water.
Microclyster
People suffering from constipation should undergo a microenema before undergoing ultrasound diagnostics ( injection of a medicinal solution into the rectum). The difference between this procedure and an ordinary enema is the reduced amount of liquid ( 100 – 200 milliliters instead of 1.5 – 2 liters).Items required to perform a microenema:
- syringe ( pear-shaped rubber balloon with an extended tip);
- medicinal solution – 100 – 200 milliliters;
- Vaseline or nourishing cream.
Solutions that can be used for microenemas:
- chamomile infusion – 2 tablespoons of dry plant, brew with 1 glass ( 250 milliliters) boiling water;
- starch solution - 1 teaspoon ( 5 grams) starch is mixed with 100 milliliters of cool water until smooth. Next, add 100 milliliters of hot water.
Fill the syringe with the prepared product and lubricate the tip with cream. Lie on your back, turn onto your left side and bend your knees, pulling them towards your chest. Insert the nozzle of the syringe into the anus to a depth of at least 5 centimeters. After the solution has been administered, you must continue to remain in a horizontal position for 15 to 20 minutes.
You can perform a microenema using medications such as microlax or norgalax. Both products are available in convenient packaging in the form of a plastic tube with a long, narrow tip. Defecation occurs within 5 to 20 minutes after using the drug.
To make a microenema using microlax or norgolax, you need to remove the seal and squeeze out a few drops of the product in order to lubricate the spout of the bottle. Next, the entire length of the tube tip must be inserted into the rectum and, by pressing on the tube, all its contents must be inserted inside.
Laxatives
Before ultrasound diagnostics of the kidneys, drugs with laxative effects will help to cope with constipation. It is necessary to take the medicine in the evening, the day before the ultrasound.Laxatives:
- forlax;
- portalak;
- laxomag;
- guttalax.
- tisasen ( based on senna) – available in the form of decoctions, infusions and tablets;
- kafiol ( senna, fig, plum, vaseline oil) – produced in the form of briquettes;
- rhubarb root – sold in powder, tablet and syrup form;
- buckthorn bark - can be in the form of syrup, extract, tablets.
You can cleanse the intestines in preparation for an ultrasound of the kidneys using suppositories for constipation. Defecation occurs quickly ( from 10 minutes to 2 hours). The rapid effect of suppositories allows them to be used in emergency preparation for ultrasound examination. The suppository should be administered after breakfast.
Suppositories with laxative effect:
- glycerin suppositories;
- Ferrolax;
- candles with rhubarb.
Bladder preparation
In order for the doctor to conduct an informative ultrasound diagnosis of the kidneys, adrenal glands and ureters, the bladder must be filled with non-carbonated liquid. To do this, before the study you should drink 2–3 glasses of water ( 500 – 700 milliliters) or other drink. It takes a certain amount of time for fluid from the stomach to enter the bladder. Therefore, you need to drink one and a half to two hours before the ultrasound.Drinks that can be consumed to fill the bladder before an ultrasound scan:
- tea ( green or black);
- unsweetened compote;
- still mineral water;
- fruit drink ( non-carbonated soft drink).
Ultrasound of the kidneys is prescribed to pregnant women if pathologies of the genitourinary system are suspected. Preparing for an ultrasound includes following a diet and filling your bladder. You need to stop eating foods that cause gas in the intestines. If a woman suffers from constipation or bloating, she should do a Microlax or Norgalax enema. In case of flatulence, within three days before the ultrasound, you should take espumizan, polysorb - enterosorbents that can be used during pregnancy.
Preparing children for kidney ultrasound
When preparing a child for ultrasound diagnostics, his age should be taken into account. If he is less than a year old, then the last feeding should be 3 to 4 hours before the ultrasound. Breast milk is digested within 3 hours, artificial formula is digested in 3.5 - 4 hours. Purees from fruits and vegetables take much longer to digest, so feeding them before an ultrasound is not recommended. If the child is between 1 and 3 years old, you should not feed him 5 hours before the procedure. Older children should stop eating 6–7 hours before the examination.
3-4 days before the kidney ultrasound, you need to exclude foods that can cause flatulence from the children's diet. If the child is prone to bloating, the child should take children's medications that reduce the amount of gas in the intestines.
Medicines for children that help reduce gas formation:
- bobotik– can be taken by children from the 28th day of life. From 10 drops ( 25 milligrams) up to 20 drops ( 50 milligrams) twice a day depending on age;
- espumisan– infants should be given 1 milliliter ( 25 drops) daily, mixing the drug with milk or formula in a separate bottle. From 1 year to 6 years – 1 milliliter 3 times a day. From 6 years – 2 milliliters ( 50 drops) three times a day
- plantex– children under one year old – 1 sachet ( 5 grams) twice a day. From 1 year to 4 years - 2 sachets ( 10 grams) twice a day.
Fluid requirements according to children's age:
- half a glass – for children from one to 2 years old;
- glass – one and a half – from 2 to 10 years;
- two glasses – from 10 to 17 years.
Preparation for ultrasound of the renal vessels
Before performing an ultrasound of the renal vessels, you must follow a diet for three days before the procedure. Foods that cause gas formation should be excluded from your diet. Preference in food before an ultrasound should be given to low-fat boiled fish and meats, water-based porridges, and weak broths. Vegetables and fruits should be heat treated before consumption. If you are prone to flatulence, you need to start taking medications that reduce the amount of gas in the intestines. For constipation, you need to do an enema or take a laxative. There are a number of foods whose consumption affects vascular tone, so you should avoid consuming them for three days before an ultrasound scan of the kidney vessels.Drinks that affect vascular tone
- coffee and coffee drinks;
- energy.
Items required for kidney ultrasound diagnostics
If a person is taking medications, there is no need to interrupt treatment. You should tell your doctor the names of the medications you are taking and the duration of their use.
If the person has previously undergone an ultrasound scan of the kidneys, adrenal glands and ureters, the doctor should be provided with information about the previous study.
When performing an ultrasound scan of the kidneys, the patient must have a wide towel or diaper with him in order to cover the couch. You also need to have wipes to remove the gel that the doctor applies to the skin.
Contraindications for kidney ultrasound
There are no absolute contraindications for ultrasound examination of the kidneys and ureters. Temporary factors that may interfere with an ultrasound or reduce its information content:
- patient's condition;
- intolerance to conductive gel ( a product that is applied to the skin to provide a contact medium between the sensor and the patient's body).
Skin disorders
During a kidney ultrasound, the doctor passes an ultrasound probe along the patient's lumbar region. Damage to the skin is an obstacle to diagnostics, because a conductive gel applied to the skin can aggravate the patient's condition.Pathologies and skin defects that can become a barrier to kidney ultrasound:
- open wounds;
- pyoderma ( purulent skin lesion);
- furunculosis ( purulent disease);
- cuts, deep scratches.
Patient's condition
Ultrasound diagnostics of the kidneys is carried out with the patient lying on his stomach, back and side. A relative contraindication for ultrasound may be a person’s condition in which he cannot remain in a horizontal position. Excess weight of the patient can interfere with diagnosis, since the fat layer reduces the quality of the resulting image.In the human body, the kidneys are an organ that works in pairs, oval in shape, and performs chemical homeostasis. The kidneys belong to the human urinary system and perform important functions:
- excretory;
- osmoregulatory;
- endocrine;
- metabolic;
- iodine-regulating.
The kidneys are located in the lumbar region, from each of them the ureter begins. More precisely, it begins at the renal pelvis and ends with the bladder. In the calyces of the kidneys and in the pelvis, urine is formed from the parenchyma of the organ, which continues its movement along the ureter and accumulates in the bladder. Parenchyma includes two substances. In the cortex there are renal glomeruli, in the medulla there are tubules. They gather in pyramids, each of which creates echogenicity. In the process of diagnosing the kidneys, each organ indicator is examined:
- dimensions;
- affected areas;
- anatomical structure;
- position.
The main function of the kidneys is the excretory function. Failures in their work can lead to irreversible consequences. If the doctor suspects an organ pathology, for example, urolithiasis, oncology and others, an ultrasound is prescribed. An examination is necessary for a correct diagnosis from a doctor. We’ll look at how to prepare for a kidney ultrasound in this article.
Before ultrasound of the kidneys in men, you need to prepare. This is in the interests, first of all, of the patient himself, since an accurate diagnosis made by a doctor will protect him from incorrect treatment. Simultaneously with the ultrasound of the kidneys, the specialist prescribes an examination of the bladder.
It is necessary to properly prepare in such a way as to eliminate all possible obstacles from the gastrointestinal tract: the doctor will be able to examine the kidneys in detail and describe them correctly.
An examination of the bladder can be carried out during medical examination, or in case of chronic kidney pathology. It is better to conduct a study if there is discomfort in the lumbar region. Ultrasound can be indicated for various changes occurring in the human body. For example, this could be an increase in blood pressure.
In children, this study is usually routine and is designed to exclude the possibility of developing pathology. The doctor should inform the patient about how to behave before an ultrasound scan of the kidneys. But in practice, in medicine, not everything is as rosy as an ordinary patient at a district clinic would like. Therefore, most often, users look for information on the Internet about how to properly approach this process.
Before the ultrasound, you must abstain from food for 7 hours. If the study is carried out during the day, then you can eat and drink water only early in the morning. The diet before the examination should consist of boiled meat and vegetables, but ultrasound is done on an empty stomach!
Additional help can be provided by any adsorbent, Infacol, Espumisan. All these medications are designed to reduce flatulence and gas formation in the intestines, that is, eliminate the obstacle to an accurate diagnosis. These medications must be taken separately. The patient must choose the drug that he trusts. Getting rid of flatulence will not only give comfort to the patient. During the study, gas formation is undesirable, especially if the patient prepared for the procedure in advance, without an unscheduled examination of the organ.
Before the ultrasound examination, the patient should refrain from eating foods that cause gas (for example, legumes and fruits)
Relieving gas will allow the doctor to see the kidneys better. In addition to the above porridge, you can eat pearl barley and buckwheat, low-fat cheese, a boiled egg (one per day), and drink tea.
You cannot eat sausage, black bread, or cabbage before the examination. And also eat vegetables, beans, peas, milk, meat broths, soda, and drink alcohol. High-fat dishes are contraindicated. An hour before the ultrasound, the patient needs to drink about 500 grams of liquid, for example water. No gas! In addition, you can drink sweet tea.
Preparing for an ultrasound for both sexes (women and men)
The study is not carried out if the patient, both men and women, has any bandages or open wounds.
An ultrasound is not performed if a gastroscopy, colonoscopy, or X-ray examination of the gastrointestinal tract is planned.
There is no need to smoke before the test.
The ultrasound is performed on an empty stomach; you should not drink carbonated water.
The patient alerts the physician to take medication if this occurs. The doctor may say no if the medications seem incompatible with the procedure.
A few days before the ultrasound, the patient is on a light diet.
What is revealed by ultrasound of an organ?
Ultrasound is a leader among instrumental studies. The study is safe for health and effective for making a diagnosis.
The device determines the size of the kidneys. The volume of the organ depends on the age of the person and its dimensions, but on average they are 7-14 cm for the right side and 8-12.0 for the left.
An increase in this organ is observed in patients with type 2 diabetes mellitus, with acromegaly, and with acute glomerulonephritis.
Wrinkling of an organ reflects irreversible pathological changes occurring in the body.
Increased echogenicity of the cortical substance is a sign of a nonspecific series that characterizes many pathologies in humans.
Using Doppler ultrasound, you can see the volume of the arteries of the kidneys and veins, the flow of blood in them, and also identify stenosis.
Ultrasound differs from excretory urography in that it detects the obstructive nature of the urinary tract, based solely on indirect symptoms. For example, by expanding the cups. The sensitivity of ultrasound for diagnosing a pathology such as hydronephrosis is 98%. Pathologies detected by ultrasound include:
- violations of the shape and structure of the organ, an increase in its size;
- inflammation;
- stones, their localization;
- lesions of purulent origin;
- neoplasms of benign and substandard composition;
- irreversible changes in kidney tissue.
How is the procedure performed?
The doctor applies a special composition to the area being examined, which acts as a conductor of ultrasound, places the sensor on the area of interest to the doctor, and begins examining the organs.
First, an ultrasound of the bladder is performed: the organ in an empty state is not visualized. After this, they look at the sections of the ureters, then go to the kidneys. To examine the second kidney, the patient turns over as recommended by the doctor.
At the doctor's request, the patient can breathe in and relax a little if the person being examined is nervous. During the ultrasound, the doctor takes several short breaks, which allow the specialist to record what he sees on the monitor.
For children, this procedure is performed after laboratory tests and if there are complaints of pain. In addition, there may be other indications. The need for this procedure in infants is determined by the pediatrician. Ultrasound is safe for children, so it can be performed in the first months of a baby’s life.
Research results
Renal emphysema
It appears due to surgical interventions and the formation of fistulas. Ultrasound for this pathology reveals echogenic zones from which the shadow path originates.
Kidney failure
In medicine, this term is collective. In simple terms, failure is a sign that the organ in question in the human body does not perform its functions. Pathology is divided into two types: acute and chronic. The reasons for the malfunction of the kidneys may not develop in them. An example of this is a disease such as diabetes.
The kidneys may not cope with the job for the following reasons:
- necrosis (acute, tubular);
- inflammation of blood vessels;
- infection of the genitourinary organs;
- elevated blood pressure, etc.
What can the renal parenchyma tell us?
With ultrasound, the indicator - the echogenicity of the parenchyma of the organ in question is compared with the same indicator, but inherent in the liver or spleen: on the monitor, the kidney parenchyma is reflected as less echogenic.
| Disease | Research problem | what was discovered |
| acute glomerulonephritis | exclude hydronephrosis, need for surgical intervention |
in the first stages of pathology from the normal state of the organ was not detected, with swelling of the renal parenchyma, an enlarged organ is reflected on the screen, the boundaries of the parenchyma are clear, echogenicity increases |
| nephrosclerosis | connective tissue sizing | echogenicity is increased due to the presence of connective tissue in the organ widespread damage to an organ may occur with a decrease in its volume |
| pyelonephritis (chronic) | determine the volume of the kidney, eliminate the need for surgical intervention |
reduction in organ size, echogenicity may remain unchanged |
| swelling of the kidney | find out the reason for this, exclude neoplasms | echogenicity of the parinchema is reduced renal pyramids are visible as echogenic zones, but may be anechoic |
Vascular pathologies
Vein thrombosis
Initially, an enlarged kidney is visible, with reduced echogenicity along the periphery; after a few weeks, the picture changes exactly the opposite; due to local hemorrhages, hypoechoic zones sometimes form in the organ.
Arterial stenosis, often in the area of infarction, are localized as hypoechoic areas in the parenchyma.
Benign neoplasm
It is visible on the monitor as an echo-negative formation, with a round shape, a clear contour, and without a wall.
Organ bruise
Ultrasound shows a change in the smooth contour of the organ with a hypoechoic focus.
Blood accumulation in the kidneys
Often on ultrasound this pathology is expressed as an echogenic contour of the organ, which is barely pronounced. The accumulation of biological fluid accompanies gyroechoic images of varying sizes. It all depends on the duration of the bleeding: if it does not stop, the affected area increases. You need to stop the blood flow.
In addition to those listed, many pathologies are often detected by ultrasound of the kidneys.
Further actions and diagnostics
The doctor, based on ultrasound data, blood and urine tests, as well as other diagnostic methods, makes a diagnosis for the patient. It can be different: it all depends on the person’s health status. And on this basis, the doctor decides how the person should be treated. Is he allowed to stay at home or not? If home treatment is not practical, the patient is admitted to a hospital for adequate treatment. If the patient can be treated at home, one must understand that he must visit the attending physician at the clinic. It is also necessary to prepare for treatment at home.
So, we have reviewed the main points in preparing for an ultrasound diagnosis of a person’s kidneys, determined which foods can be eaten and which liquids can be drunk. If a person has discomfort and pain, one should not ignore the doctor. The specialist is required to conduct a series of studies indicating the presence or absence of pathology in a person. Ultrasound preparation is simple. You need to understand that this method is reliable and you need to do an examination.
Content
Ultrasound examination (ultrasound) is an effective and safe diagnostic method. Used to identify diseases of the urinary system. The kidneys are well suited for this type of study. In order for the picture to be clear and the doctor to be able to make a diagnosis, it is important to properly prepare for the ultrasound. Recommendations before the procedure include selective nutrition, medication and a number of other manipulations.
Why is an ultrasound scan of the kidneys done?
Ultrasound is a common instrumental examination method in case of problems with the pelvic organs and kidneys. The procedure is safe and therefore suitable even for pregnant women. Unlike computed tomography, ultrasound is performed without the use of a contrast agent and allows you to examine stones and sand in the kidneys, cysts, neoplasms and the general condition of the internal organs. The procedure has no contraindications; there is no need to take a long break between examinations.
Ultrasound echography will show changes in the renal parenchyma and help determine the presence of stones, neoplasms, and organ displacement. The device forms an image due to the peculiarities of the reflection of sound waves from tissues of different densities. Sound easily passes through liquid, encountering difficulty only in the form of gases. Doppler ultrasound helps monitor the movement of blood in the vessels of the kidneys. The Doppler effect used in this method implies different frequencies of ultrasonic waves reflected by blood components.
An ultrasound machine has a transducer that emits sound waves that are too high in frequency for the human ear to hear. Sound waves penetrate through the skin to the internal organs, are reflected from them and again end up on the transducer, which transmits them to processing devices and then to the device’s display. The gel that is applied to the transducer not only makes it easier to glide over the skin, but also prevents air from being an obstacle.
Air creates interference and distortion, being the medium through which ultrasonic waves travel the slowest. They pass most quickly through bones. During an ultrasound examination of the kidneys, it is possible to see the blood flow inside the organs. A weak signal or its complete absence may be a sign of low patency or blockage of the vessel.
Indications
Kidney ultrasound is often prescribed for regularly high blood pressure, which cannot be reduced. Also on the list of common indications for ultrasound examination:
- pain in the lumbar region;
- changes in urine tests;
- renal colic;
- failure of the kidney;
- enuresis;
- loss of strength, weakness;
- traumatic injuries;
- diseases of the endocrine system;
- diagnosis of neoplasms;
- infectious diseases, inflammatory processes;
- kidney transplantation (monitoring the rehabilitation process after surgery);
- medical examinations.
Preparing the patient for a kidney ultrasound
The simple rules for preparing for the procedure are clear to many, but not everyone is familiar with the nuances that are often ignored. It is important to follow the following series of rules:
- An hour before the procedure, you need to drink 2-4 glasses of plain water to fill the bladder with non-carbonated liquid.
- Bring a towel for the procedure to wipe off any remaining gel after the ultrasound.
- The evening before the test, choose a light meal for dinner that will not be difficult to digest for a long time. Meals must be taken no later than 19:00. If the entire abdominal cavity is being examined, you should not eat anything before the procedure.
- Preparing for a kidney ultrasound is no different for women and men; the rules are identical. There is a nuance for representatives of the stronger sex: preparation for an ultrasound of the kidneys in men includes giving up smoking and alcohol and refraining from injury (if there are open wounds, an ultrasound is not performed).
What can you eat
A diet before a kidney ultrasound will be useful three days before the procedure, and eight hours before the diagnosis you should not eat anything at all. If the examination is scheduled for the second half of the day, you can have breakfast, but no later than 11 o’clock in the afternoon. The diet must be determined by a doctor; such a menu includes: low-fat hard cheese, porridge (barley, oatmeal, buckwheat), boiled poultry and animal meat, steamed fish (hake or pollock), one egg per day.
What foods should you not eat?
It is important 3 days before the procedure to exclude from the menu foods that contribute to gas formation: dairy products, soda, fresh vegetables and fruits, brown bread, beer, cabbage, legumes. It is better for a patient who is preparing for a kidney examination to abstain from fermented milk products, alcohol, juices, rich meat soups, baked goods (pastries, cakes, cookies, buns), chocolate, mushrooms, and sausages.
Drugs
Patients who are prone to flatulence (bloating) should start taking sorbents such as activated carbon or Espumisan 3 days before the procedure; it is important to get rid of gases in order to improve access to the kidneys for a more accurate diagnosis. In some cases, the doctor may prescribe a cleansing enema; it should be done the evening before the procedure and in the morning. If the patient suffers from constipation, then laxatives should be taken on the eve of the procedure. For prevention, you can take Mezim or Pancreatin after meals, they help food to be absorbed faster.
How to do a kidney ultrasound
Ultrasound diagnostics is harmless and painless. During the procedure, the patient lies on the couch in several positions: on the stomach, back and side. To exclude nephroptosis - in a standing position. During the procedure, the patient is asked to inhale and exhale. Before starting ultrasound diagnostics, the doctor applies a conductive gel to the skin and moves an ultrasonic wave converter along it. They are inaudible to the human ear. The reflected signal is presented in the form of a picture, which the doctor studies on the monitor.
The image is formed due to different wave speeds: ultrasound travels faster through bone tissue, and slower through air. The contours of the kidneys are visible on the monitor, and neoplasms can be distinguished. The doctor makes a transcript and prints it out for the patient. The only downside is the cool, sticky gel that can stain your clothes, so don't forget to bring a towel for the procedure.
Ultrasound interpretation
Ultrasound only gives a general picture, and clinical diagnosis is carried out by the attending physician. The method helps to determine deviations from the norm; they are described in the conclusion, on the basis of which the doctor draws conclusions and prescribes treatment or additional procedures. The data in the transcript is checked against the norm. If the kidneys are enlarged, this is a sign of inflammation. Impaired mobility also indicates the presence of a number of diseases. Ultrasound determines the morphological and anatomical features of the kidneys, such as:
- structure, size and shape of organs;
- location;
- shape and size of the pelvis;
- thickness of the functional layer.
Normal indicators
In a healthy state, the organ has a bean shape and clear outline. The left kidney is higher than the right. They are almost identical in size, moving a couple of centimeters when breathing. The kidneys are located behind the peritoneum, on both sides of the spine (at the level of the 12th thoracic, 1st and 2nd lumbar vertebrae). The urinary organ is surrounded on all sides by fatty tissue. Normal values for children are very different from those for adults. They change from age to age. Normally, an adult kidney has the following parameters:
Pathologies
An ultrasound gives an accurate picture and helps identify the presence of problems with the kidneys or adrenal glands. Diagnosis often reveals:
- Urolithiasis. Salts deposited in the kidneys form stones and sand. These growths complicate the passage of urine; the accumulated excess fluid compresses the parenchymal tissue, which atrophies over time.
- The presence of tumors and cysts that can disrupt the functioning of the organ.
- Curvature or narrowing of the ureter. Leads to problems with urination and malfunction of the entire genitourinary system. Pathology leads to the accumulation of toxins in the body.
- Pyelonephritis. The disease causes constant pain in the lumbar region, high fever and pain when urinating. Pyelonephritis is an inflammation caused by bacteria that affects the pelvis, calyces or parenchyma.
- Purulent lesions.
- Hydronephrosis.
- Congenital anomalies in the development of the ureters and kidneys.
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Diagnosis of diseases of the urinary system, carried out in a timely manner and providing the attending physician with reliable data, is very important. In many cases, it makes it possible to begin adequate therapy in the early stages of the disease, helping to preserve the patient’s health and often life.
What are the features of kidney ultrasound?
One of the most modern diagnostic methods, it differs from other methods in its absolute safety, high information content, and the ability to carry it out repeatedly, including for screening, in the same patient. But each patient has his own anatomical characteristics, which also apply to the kidneys. In addition, the location of the kidneys in the retroperitoneal space (lumbar region) requires a certain skill and qualification of a diagnostician. This determines the need to conduct ultrasonography in two positions of the person being studied: on the side and on the back. And the location of many organs of the abdominal cavity, as if “standing up as a wall” in front of the beam of ultrasonic waves, requires that during an ultrasound of the kidneys, preparation for the study should be carried out properly.
The kidneys are located in the retroperitoneum, on both sides of the spinal column
A type of simple ultrasound scan, namely Doppler sonography of the renal vessels, is also performed in two patient positions. The information obtained from this study is extremely important for diagnosing such serious diseases as thrombosis, thrombophlebitis, stenosis and aneurysm of blood vessels, compression of them by a growing tumor. Therefore, the accuracy of the results should be maximum, and, therefore, preparation for ultrasound of the kidneys in women, men and children, carried out by Doppler ultrasound, is of great importance.
The position of the patient on his side when the upper kidney is scanned can be called the most preferable. In this case, between the device’s sensor and the organ there is a minimum amount of soft tissue, the condition of which affects the result the least. But still, in this position of the patient, the diagnostician “does not see” some structural formations of the urinary system and vascular bundles completely, and cannot assess the effect of the abdominal or pelvic organs on the kidneys.
Therefore, ultrasound of the kidneys in men, women, and children of any age is also performed in the supine position. In this case, ultrasound waves, before reaching the kidney tissue, pass through a large space filled with loops of the small intestine, pancreas, gall bladder, blood vessels and lymph nodes. The ultrasound beam overcomes obstacles layer by layer: the skin, subcutaneous fatty tissue (in many patients it is significantly pronounced, which complicates the study), the muscle layer, and internal organs covered by the mesentery. Only after this, having gone beyond the abdominal cavity, ultrasound penetrates into the retroperitoneal space and finally reaches its target: the kidneys and renal vessels.
In the lateral position, the kidneys are closest to the sensor
All these formations consist predominantly of soft tissue and have moderate echogenicity, like the renal parenchyma. This means that ultrasonic waves pass through the boundaries of various tissues of similar density, without being able to significantly linger at the boundary of these media and thus clearly record their presence on the monitor screen. If, in addition to this natural physiological aspect, the preparation for the study during ultrasound of the kidneys is carried out poorly, then the condition of the abdominal organs will actively interfere with obtaining valuable diagnostic information.
How to prepare for a kidney ultrasound correctly so that the time and effort spent on the session are not in vain? What are the stages of preparation for the procedure before an ultrasound scan of the kidneys and what can or cannot the patient do? Let's consider these points in more detail.
How to prepare for a kidney ultrasound correctly
The attending physician who prescribes this test for an adult patient must clearly explain what the measures are to properly prepare for an ultrasound. If the procedure is to be performed on a child, then this information should be communicated to the parents.
The child must be properly prepared before the ultrasound
The patient's actions are primarily aimed at correcting the condition of the intestines. After all, it is intestinal loops filled with excess gases or compacted food masses that can interfere with the visualization of the kidneys during the study. Therefore, the main directions of preparation before ultrasound of the kidneys are as follows:
- following a certain diet;
- special drinking regime;
- taking medications if necessary.
As for changes in diet, you need to start preparing not the day before, but in advance. The exclusion of foods that cause increased formation of gases in the intestines and lead to “pneumatization”, which makes ultrasound very difficult, must begin 3 days before the procedure. This is the first stage of preparation, and it consists of prohibiting the consumption of the following products:
- all legumes, cabbage, vegetables and fruits in raw form;
- milk and fermented milk products;
- black bread and yeast baked goods;
- alcohol, carbonated drinks;
- smoked meats, fatty and fried foods.
To maintain your strength before the session and prepare the body, you are allowed to eat boiled or stewed meat, fish and poultry, hard cheese, boiled eggs, cereal porridge, non-concentrated soups and broths.
Yeast baked goods and bread should be temporarily avoided before the procedure.
The second stage is refusing food 8 hours, or preferably 12, before the procedure. On the day of the ultrasound, it is better to perform it on an empty stomach, but if the session is scheduled for the second half of the day, then you can eat until 10 am. This relaxation in the rules applies most to pediatric patients.
Concerning drinking regime, then it is not limited or strengthened, but you need to drink boiled water or weak tea for 3 days. Immediately before the study, 0.5-1 hour, you need to drink about 500 ml of liquid (water, tea). If you want to go to the toilet, it is important to wait until the end of the session. This measure is necessary so that the filling of the bladder with liquid is at least 200 ml, which will create “comfortable” conditions for the passage of ultrasonic waves.
In some cases, certain medication measures are prescribed to ensure proper preparation for a kidney ultrasound. Thus, it is possible to minimize the gas filling of the intestines with the help of sorbent agents. For example, activated or white carbon in a dosage of 0.25 g (1 tablet) per 10 kg of patient weight, Sorbex, Smecta. So-called “carminative” drugs (Espumizan) also help.
If the patient suffers from chronic constipation, it is recommended to do an enema or use microenema "Microlax", and also start taking laxatives (Guttalax, Picolax, Senna) 2-3 days before. With the permission of the attending physician, if the patient has enzymatic insufficiency of the intestines, you can take Mezim, Cholenzym or Pancreatin in the prescribed dosage.
Activated charcoal is excellent in preparing for a kidney ultrasound
In some cases, before an ultrasound, on the contrary, it is necessary to take some kind of diuretic: with a tendency to edema, pathology of the kidneys or heart, with various dysuric disorders. Hypothiazide, Furosemide or another diuretic drug is prescribed 20-30 minutes before the ultrasound scanning session.
Strict adherence to all preparation rules is mandatory, but at the same time, it is not too burdensome for the patient. The implementation of these measures will ensure the receipt of accurate information, its correct interpretation by the doctor, and, consequently, the prescription of adequate treatment in accordance with the diagnosis.
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