Point-of-care ultrasound no diagnóstico e na decisão terapêutica de pacientes com insuficiência renal aguda: série de casos  : Point-of-care ultrasound in diagnosis and decisions for patients with acute renal failure: case series

Yoshimi José Ávila Watanabe; João Victor Marques Guedes; Lívia Maria Rezende Carvalho; André Oliveira Baldoni; Alba Otoni

doi:10.17765/2176-9206.2025v18e13103

Authors

Yoshimi José Ávila Watanabe Federal University of Sao Joao del Rei https://orcid.org/0000-0002-6038-2501
João Victor Marques Guedes Federal University of Sao Joao del Rei https://orcid.org/0000-0002-4812-7030
Lívia Maria Rezende Carvalho Federal University of Sao Joao del Rei https://orcid.org/0000-0003-1548-5330
André Oliveira Baldoni Federal University of Sao Joao del Rei https://orcid.org/0000-0001-6379-0415
Alba Otoni Federal University of Sao Joao del Rei https://orcid.org/0000-0002-8126-3026

DOI:

https://doi.org/10.17765/2176-9206.2025v18e13103

Keywords:

Case reports, Acute kidney injury, Ultrasound

Abstract

Bedside ultrasound, known as Point-of-Care Ultrasound (POCUS), has proven to be a valuable tool in several areas of medicine. In nephrology, POCUS has gained prominence as a non-invasive and easy-to-apply technique to aid in the diagnosis and management of various renal conditions. Objective: to evaluate POCUS as an auxiliary tool in the diagnosis and therapeutic decision of patients with acute renal failure. In this study, we report a series of cases that illustrate the successful use of POCUS in nephrology practice, from October to December 2022. Six cases of patients admitted to an intensive care unit with different clinical manifestations related to acute kidney disease were included. All patients underwent renal ultrasound examinations using a mobile POCUS device. Our results demonstrated that POCUS was able to provide relevant clinical information in all the events studied, allowing for faster and more assertive decision-making in patients with different clinical presentations, such as: rhabdomyolysis, pre-renal injury, liver disease, heart failure with reduced ejection fraction (ICEFER), obstructive uropathy, and sepsis. We conclude that POCUS is a promising tool in nephrology practice, offering significant advantages in terms of agility and safety for the care of patients with acute renal failure. Its use allowed a quick and accurate assessment of renal structures, helping in the diagnosis, monitoring, and management of various nephrological conditions.

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Author Biographies

Yoshimi José Ávila Watanabe, Federal University of Sao Joao del Rei

Beginning of PhD at UFSJ (Federal University of São João del Rei) in Health Sciences, with emphasis on Epidemiology and Public Health, which focuses on the study of "Weaning from hemodialysis in patients with acute renal failure in intensive care" supervised by Dr. Alba Otoni. Master's degree in Biotechnology from UFSJ (Federal University of São João del Rei) with emphasis on Entrepreneurship. Started in 2013, completed in 2015. Graduated in Medicine from the Federal University of Minas Gerais (1991) and graduated in Computer Science from the University Center of Formiga (2002). He is currently a Nephrologist at Hospital São Joao de Deus - Divinópolis. Admitted as Preceptor in Nephrology at the University of Itaúna, MG in 2013 and ended activities in 2015. Has experience in the area of Computer Science, with emphasis on Computer Systems in the database area. We develop computer systems for management in Nephrology Clinics (NEFRODATA, 1998)), the management system for Clinical Analysis Laboratories (AUTOLAC, 2005)) and work in the process of developing the system for managing Clinics with an emphasis on mobile and lightweight technologies (MEU CONSULTÓRIO, 2017). We participate in the composition of the Brazilian Dialysis Registry, providing technical consultancy for the process with the Brazilian Society of Nephrology. We are currently participating in the composition of a support group for the creation of the Brazilian Nephrology Registry. The Brazilian Registry is composed of members of the Brazilian Society of Nephrology, whose objective is to collect data from Nephrology Centers in the Brazilian states that perform Renal Replacement Therapy. The Group that makes up the commission must periodically publish national epidemiological data efficiently and promptly, providing the scientific community, public agencies and private sectors with information that can support decision-making and planning in healthcare for chronic renal patients in Brazil.

João Victor Marques Guedes, Federal University of Sao Joao del Rei

He holds a degree in Pharmacy from the Federal University of São João Del Rei (UFSJ-CCO) and a degree in Psychology from the State University of Minas Gerais (UEMG - Divinópolis Unit). He holds a Master's degree in Health Sciences from the Postgraduate Program in Health Sciences (UFSJ-CCO). He currently works as a Psychologist in a private practice. He conducts research in the areas of Epidemiology and Public Health, Clinical Pharmacy, Biochemistry and Clinical Hematology, Nephrology and Psychology.

Lívia Maria Rezende Carvalho, Federal University of Sao Joao del Rei

Nurse at the Federal University of São João del Rei, Dona Lindu Central West Campus (UFSJ-CCO). Participant of the Center for Studies and Research in Adult and Elderly Health (NEP-SAI), recognized by DGP-CNPq. Scholarship holder in the Scientific Initiation projects entitled: Analysis of Professional Practices for Immunization Errors (2021-2022), Prevalence of proteinuria in patients with non-dialysis diabetic kidney disease and associated factors (2022-2023); Factors associated with readmission to the intensive care unit of patients who developed Acute Kidney Injury during a previous hospitalization (2023-2024). Volunteer for the research "Ultrasound as a complementary criterion for indicating weaning from hemodialysis in patients with acute renal dysfunction". Technical-scientific productions: Kidney Diseases, Diabetes Mellitus and Occupational Health.

André Oliveira Baldoni, Federal University of Sao Joao del Rei

Pro-Rector of Research and Postgraduate Studies at the Federal University of São João del-Rei (UFSJ) and CNPq Productivity Scholarship - PQ-2 (CNPq Call No. 09/2022). . Graduated in Pharmacy, Clinical Analysis modality, from the Federal University of Alfenas-MG (UNIFAL-MG) in 2006. Master's (2010) and Doctorate (2013) in Pharmaceutical Sciences from the Faculty of Pharmaceutical Sciences of Ribeirão Preto - University of São Paulo (FCFRP-USP) (2010), in the area of Pharmaceutical Assistance and Clinical Pharmacy. Organizer of the two editions of the book Pharmacotherapy: Therapeutic guide to the most prevalent diseases (2013 and 2017). Master's and doctoral advisor in the Postgraduate Program in Health Sciences and master's degree in the Postgraduate Program in Pharmaceutical Sciences at UFSJ. Coordinator of the Center for Teaching and Research in Clinical Pharmacy (NEPeFaC) http://dgp.cnpq.br/dgp/espelhogrupo/0689581579898478 and https://ufsj.edu.br/nepefac/index.php. He was coordinator of the Postgraduate Program in Pharmaceutical Sciences at UFSJ (2019-2020). He is a member of the Brazilian Society of Pharmaceutical Sciences (ABCF), the "Brazil Chapter - International Society for Pharmacoepidemiology (ISPE)" and the Brazilian Deprescription Group http://www.sbrafh.org.br/inicial/desprescricao/. He was a member of the UFSJ/CCO Research Ethics Committee (2014 to 2017), of the Clinical Pharmacy Advisory Committee of the Regional Pharmacy Council of the State of Minas Gerais (CRF-MG), from 2016 to 2017 and of the Scientific Initiation Committee of UFSJ (2015 - 2019). He was coordinator of the Clinical Pharmacy service of the UFSJ university outpatient clinic and of PET-Saúde/GraduaSUS (Education Program through Work for Health) Clinical Pharmacy. He works in the areas of Pharmacotherapy, Pharmaceutical Assistance, Clinical Pharmacy, Pharmaceutical Care, Pharmacoepidemiology, Geriatrics.

Alba Otoni, Federal University of Sao Joao del Rei

Nurse from the School of Nursing of UFMG; Specialist in Nephrology Nursing from the Brazilian Society of Nursing in Nephrology; Master in Nursing from the School of Nursing of UFMG - research area - Markers of integrity of the peritoneal membrane of chronic renal patients in CAPD; PhD in Health Sciences from the Postgraduate Program in Infectology and Tropical Medicine / School of Medicine of the Federal University of Minas Gerais (UFMG) / research area - Immunology of renal lesions in patients with schistosomiasis, hepatosplenic form (2011). Post-Doctorate in Health Sciences from the Postgraduate Program in Infectology and Tropical Medicine / School of Medicine of the Federal University of Minas Gerais (UFMG) / focus - Immunology of renal lesions (2015). Currently Associate Professor II at the Federal University of São João Del Rei - CCO Campus - D.Lindu. Divinópolis-MG; Collaborating researcher of the Research Groups: Center for Research in Epidemiology and Public Health - UFSJ; and Center of Excellence in the Study of Biomarkers in Human Diseases (NEBiD) - UFMG. Currently in Post-Doctorate at the Federal University of Alfenas. Focus: Preventive Nephrology: Assistance to Chronic Kidney Disease in Primary Health Care.

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