MDCalc

Licurse Score for Renal Ultrasound

Predicts probability of hydronephrosis on renal ultrasonography (RUS) requiring urologic intervention in adult patients with acute kidney injury.

History of hydronephrosis
Documented history of HN in the medical record or any imaging history of HN in the 2 years prior to the current RUS

Result:

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Advice
  • Interpret the score alongside clinical findings; if obstruction is strongly suspected or the patient is otherwise high-risk, obtain imaging regardless of score.
  • Patients with known renal abnormalities (horseshoe kidney, solitary kidney, renal transplant) are high-risk and should undergo renal ultrasound irrespective of score, as delayed recognition of obstruction can have serious consequences.
Management
  • Low risk (score ≤2 pts): 
    • Consider deferring renal ultrasound.
    • Focus evaluation and management on prerenal and intrinsic causes.
    • Reassess if the clinical picture changes or AKI persists despite appropriate treatment for prerenal/intrinsic etiologies.
  • Medium risk (score 3):
    • Weigh the need for imaging against other clinical clues.
    • Consider nephrology consultation.
  • High risk (score ≥4):
    • Obtain a renal ultrasound.
    • Consult urology if obstruction is suspected or confirmed.
    • If confirmed, proceed to decompression (e.g., catheter, nephrostomy, stent) and address reversible contributors (e.g., BPH treatment).
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