Division of Renal Medicine

THE RENAL ULTRASONOGRAPHY TRAINING PROGRAM AT EMORY

The renal ultrasonography program at Emory began in January, 1994. Since then, over 5900 ultrasound studies have been performed and over 40 clinical fellows have been trained. Currently, approximately 100 studies are performed each month. The following types of examinations are performed:

  • diagnostic studies of native kidneys
  • diagnostic studies of renal allografts
  • screening of end-stage kidneys for carcinoma
  • guidance for percutaneous renal biopsy
  • diagnostic studies of urinary bladders and measurement of post-void bladder volume
  • visualization of veins for central venous catheterization

Formal, comprehensive training is incorporated into the Nephrology Fellowship Training Program. Fellows rotate through the ultrasound service for several months, performing all the studies under faculty supervision, and then participating in the interpretation and generation of reports. The number and type of all studies performed by each fellow are recorded and fellows receive certificates documenting their training and experience in ultrasonography.

WHY YOU SHOULD INCORPORATE NEPHROLOGY INTO YOUR PRACTICE

There are many reasons why you should incorporate ultrasonography into your practice. These include:

  • Patient convenience: outpatient ultrasounds can be performed in the office; inpatient studies and biopsies can be performed at the bedside.
  • Physician convenience: ultrasonography can be done during the initial evaluation; you can have an immediate answer when your patient develops acute renal failure, hematuria, or pain; renal biopsies can be performed at your convenience.
  • Improved patient care: you get answers more quickly and you do a better job of interpreting the results since you are familiar with the clinical situation and know what you are looking for.
  • Economic feasibility: The cost of equipment is reasonable (about $25,000) and training is not difficult. You won't get rich doing ultrasounds but you won't lose money either. Only 50-60 outpatient studies are necessary per year to recover equipment costs.
  • Enjoyment and satisfaction: Ultrasonography is fun, increases the range of services you can provide, and makes you a more complete nephrologist. It certainly makes the practice of nephrology more interesting and is a very popular rotation for the renal fellows.

YES YOU CAN DO ULTRASONOGRAPHY AND NOBODY CAN STOP YOU

  • There is no law or rule that states that prohibits nephrologists from doing ultrasonography.
  • The kidney is one of the easiest abdominal organs to image.
  • There is little anatomic variation and the range of pathologies is small.
  • They're your patients.
  • Everyone else is doing it (cardiology, OB-GYN, urology, endocrinology, breast surgery) so why shouldn't you.
  • Renal biopsy is a nephrology procedure and since it requires ultrasound guidance, nephrologists need to be performing ultrasonography and have access to equipment.
  • Training is available.
  • Most importantly: ultrasonography by nephrologists improves patient care.