Licurse et al reported a model for predicting hydronephrosis in a patient with acute kidney injury. This can help to identify a patient who may benefit from renal ultrasonography. The authors are from Yale University.
Patient selection: acute kidney injury
Parameters:
(1) history of hydronephrosis
(2) recurrent urinary tract infections (UTI)
(3) diagnosis consistent with possible obstruction (benign prostatic hyperplasia, abdominal or pelvic cancer, neurogenic bladder, previous pelvic surgery, single functional kidney
(4) race
(5) exposure to inpatient nephrotoxic medications
(6) congestive heart failure
(7) prerenal AKI
Parameter
Finding
Points
history of hydronephrosis
no
0
yes
1
recurrent UTI
no
0
yes
1
possible obstruction
no
0
yes
1
race
black
0
nonblack
1
nephrotoxic drug exposure
yes
0
no
1
congestive heart failure
yes
0
no
1
prerenal AKI
yes
0
no
1
total score =
= SUM(points for all 7 parameters)
Interpretation:
• minimum score: 0
• maximum score: 7
Score
Risk Hydronephrosis
0 to 2
<= 20%
3
20-40%
4 to 7
> 40%
Performance:
• The area under the ROC curve is 0.79.
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