The evaluation of renal failure often starts with the classical pre-renal, renal and post renal causalities delineating a practical workable approach in its differential diagnosis. Accordingly the history, physical exam, urinalysis and kidney-bladder sonography are standard resources in the initial approach of renal diseases. Indeed, ultrasonography have very well established role as an important adjuvant for post renal diagnosis of renal failure. Nevertheless, in the clinical setting most of the causes of kidney failure are pre-renal and renal. In addition some renal causes of kidney failure are manifestations of systemic diseases in which sonography can be diagnostically analogous to the history and physical examination. In this paper we explore the point of care (POC) sonographic contributory signs in the evaluation and management of renal failure extending beyond the traditional kidney biopsy, placement of central lines or screening of hydronephrosis.
