Editorial comment on “The value of unenhanced multi-detector computed tomography versus three-dimensional ultrasound in evaluating patients with impaired renal function and hematuria”

Abstract

The issue of how best to image patients with hematuria and impaired renal function has always been controversial and remains controversial, particularly in recent years with the development and continued refinement of multi-detector computed tomography (MDCT).Patients with impaired renal function are more likely to have urinary stone disease and urothelial cancer than those with normal renal function. Thus, retrograde pyelography (RP) is more valuable for evaluating hematuria in patients with impaired renal function than in patients with normal renal function. Among the patients with impaired renal function, uremic patients are at higher risk of having urothelial cancer. Therefore, for the noncalcular causes of hematuria, it is crucial to perform RP and/or cystoscopy, as standard of reference, for patients with impaired renal function, especially for those with uremia [1]. Low-dose CT offers much greater sensitivities for the detection of urinary tract calculi than radiography at doses equivalent to conventional radiography. Ultrasound (US) alone is insufficient for imaging