Altered mental status, acute renal failure ULTRASOUND KIDNEYSRIGHT KIDNEY: The right kidney measures 10.9 cm in length. There is marked hydronephrosis seen with significant internal debris within the collecting system. The cortex has increased echogenicity and is thinned. There is a proximal ureteral calculus seen that appears to be obstructing. This measures 1.2 cm x 0.5 cm.LEFT KIDNEY: The left kidney measures 8.3 cm in length. There is moderate degree hydronephrosis seen. There is a hypoechoic area redemonstrated in the upper pole measuring 3.4 cm x 3.1 cm x 3.7 cm, however this is poorly assessed. There is increased echogenicity of the cortex.OTHER: Echogenic structure(s) seen within the bladder which may represent ureteral stent placement.
1. There is right greater than left moderate to marked hydronephrosis with a significant amount of debris, concerning for pyonephrosis or superimposed infection. There is also a proximal right ureteral calculus measuring 1.2 cm x 0.5 cm, suspected to be obstructing.2. Bilaterally there is increased renal cortical echogenicity consistent with medical renal disease.3. Ureteral stent placement questioned, see above; if so correlate clinically for appropriate functioning due to presence of bilateral hydronephrosis.