- Duplex Doppler Ultrasound
- Non-invasive and commonly used as a screening test.
- Assesses blood flow velocity in the renal arteries.
- CT Angiography (CTA)
- Provides detailed images of the renal arteries.
- Involves contrast material, so it is not suitable for patients with severe renal dysfunction.
- Magnetic Resonance Angiography (MRA)
- Useful for patients with compromised renal function as it can use gadolinium instead of iodinated contrast.
- Renal Arteriography
- Gold standard diagnostic test.
- Invasive but provides detailed images and allows for simultaneous intervention (angioplasty).
- Captopril Renography
- Functional test that evaluates kidney function pre- and post-captopril administration to detect renovascular hypertension.
Management of Renal Artery Stenosis
Lifestyle Modifications:
- Low-sodium diet, weight loss, and smoking cessation.
Pharmacological Therapy:
- ACE inhibitors/ARBs: Preferred for blood pressure control but used cautiously if bilateral stenosis exists.
- Calcium channel blockers and beta-blockers: Alternatives for blood pressure management.
Angioplasty with Stenting:
- Indicated in patients with refractory hypertension or progressive renal function decline.
Surgical Revascularization:
- Reserved for patients unsuitable for angioplasty or with complex arterial anatomy.
- For patients who progress to end-stage renal disease despite treatment.
