Key messages

• Ultrasound and, less frequently, CT are the preferred investigations in the critical care setting.

• The main questions being asked of diagnostic imaging in the critically ill patient with impaired renal function are as follows. What size are the kidneys? Can obstruction be detected or excluded with confidence?

• Renal failure due to bilateral renal obstruction requires an urgent CT scan because of its superior resolution of the retroperitoneum.

• In renal trauma ultrasound will demonstrate perirenal hematoma, urinoma, and the integrity of the renal artery and vein. However, spiral CT is more informative and allows staging of injury.

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