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Ultrasound scans for people on dialysis

Posted Apr 01 2011 9:14pm
I was in the East Marredpally unit of NephroPlus a couple of days back. A patient's son wanted to speak to me. He said his father was advised to undergo a KUB Ultrasound Scan and they went to Apollo Hospital in Secunderabad. There, the assisting nurse asked his father, the patient, to drink a lot of water and make sure his bladder was full. Only then could they do the scan.

The family was in a dilemma. They had, all along, been advised to restrict his fluids to a liter per day. Now, here was a nurse asking him to drink a lot more. They explained this to the nurse. The nurse wouldn't listen. She insisted that the scan couldn't be done without a full bladder. The family relented. The patient was made to drink about three liters of water in a span of about an hour. The scan was done.

By next morning, the patient was overloaded with fluid. His feet were swollen and he could barely walk.

This is so outrageous!

First, the bladder wouldn't have been full even if the patient would have had 100 liters of water. Simply because his kidneys weren't functioning. Second, in all patients with kidney failure ultrasound scans are routinely done with empty bladders. There is simply no choice. This shows the complete ignorance and apathy of the staff at the hospital. Again, it is not only this hospital. I have myself been asked several times to drink a lot of water when I went in for an ultrasound scan. I simply tell them my bladder is already full. The radiologist usually understands. It is the staff outside that does not.

This is a very basic facet of kidney disease that should be taught to anyone who is likely to deal with these kinds of cases. Ultrasound scanning staff to start with. Nephrologists of each hospital should probably take the lead on this and instruct the departments to make this a part of the rules/handbook/training or whatever such mechanism might be available.

If the patient is on dialysis, there is NO NEED FOR A FULL BLADDER. DO NOT DRINK ANY WATER AT ALL. If the team there insists, refuse to do the scan and ask them to speak to the nephrologist.
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