[Ultrasonography diagnosis of medical nephropathies: the clinician's needs]

Echography and echo-color Doppler represents a relatively new tool in the management of patients with renal disease. We report here the flow-chart we currently use to evaluate such patients, and emphasize the role of echography and of echo color Doppler in diagnosing and monitoring medical renal diseases. Besides gaining informations on renal morphology and texture, echo color Doppler provides clinically relevant data on blood flow and vascular resistivity. Changes of these variables are useful in the differential diagnosis between functional and organic acute renal failure. In addition, as histology remains essential in diagnosing parenchimal disease, echography has a role, allowing guided biopsy, safer approach, and monitoring of possible complications. Finally, when diagnosis has been obtained and therapy has been started, echography is useful in monitoring long term changes of size, texture and blood flow.