Effective ultrasound diagnostics necessitate expert clinical knowledge and optimally complete access to all relevant clinical information regarding the patient and patient history as well as a clear and specific nephrological question to be answered. An advantage of ultrasound is the physical proximity to the patient with a bedside imaging thereby being able to interactively communicate and enable a more precise diagnosis or differential diagnosis. Renal length (standard value 9-12cm) can be readily measured, but reproducible measurement of the thickness of the renal cortex is more problematic. For the diagnostics of an increased echogenicity, the renal parenchyma should first be compared with the echogenicity of the renal medulla. The "twinkling artefact" and an analysis of the ureteral jet are helpful in the diagnosis of urolithiasis in the efferent urinary tract. New technical developments, such as the use of pocket ultrasound devices expand the clinical use and availability of ultrasound diagnostics. Contrast-enhanced ultrasound with microbubbles provides more precise perfusion information of the abdominal organs, particularly the kidneys and can be successfully used in the differential diagnosis of unclear cystic renal lesions as well as for renovascular evaluation, including perfusion analysis of renal transplants.
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