title: Doppler ultrasound and renal artery stenosis: An overview.
abstract: Renovascular disease is a complex disorder, most commonly caused by fibromuscular dysplasia and atherosclerotic diseases. It can be found in one of three forms: asymptomatic renal artery stenosis (RAS), renovascular hypertension, and ischemic nephropathy. Particularly, the atherosclerotic form is a progressive disease that may lead to gradual and silent loss of renal function. Thus, early diagnosis of RAS is an important clinical objective since interventional therapy may improve or cure hypertension and preserve renal function. Screening for RAS is indicated in suspected renovascular hypertension or ischemic nephropathy, in order to identify patients in whom an endoluminal or surgical revascularization is advisable. Screening tests for RAS have improved considerably over the last decade. While captopril renography was widely used in the past, Doppler ultrasound (US) of the renal arteries (RAs), angio-CT, or magnetic resonance angiography (MRA) have replaced other modalities and they are now considered the screening tests of choice. An arteriogram is rarely needed for diagnostic purposes only. Color-Doppler US (CDUS) is a noninvasive, repeatable, relatively inexpensive diagnostic procedure which can accurately screen for renovascular diseases if performed by an expert. Moreover, the evaluation of the resistive index (RI) at Doppler US may be very useful in RAS affected patients for predicting the response to revascularization. However, when a discrepancy exists between clinical data and the results of Doppler US, additional tests are mandatory.
authors: Department of Nephrology, Dialysis and Internal Medicine, AOU Policlinico "Vittorio Emanuele", Catania, Italy.
authors: A
authors: A
authors: Granata
authors: F
authors: F
authors: Fiorini
authors: S
authors: S
authors: Andrulli
authors: F
authors: F
authors: Logias
authors: M
authors: M
authors: Gallieni
authors: G
authors: G
authors: Romano
authors: E
authors: E
authors: Sicurezza
authors: C E
authors: CE
authors: Fiore
keywords: Doppler ultrasound; Ischemic nephropathy; Renal artery stenosis; Renovascular disease
references: Eur Radiol. 2007 Aug;17(8):1995-2008
references: 17351779
references: Ann Vasc Surg. 2000 Mar;14(2):118-24
references: 10742425
references: J Hypertens. 1996 Apr;14(4):519-24
references: 8761903
references: Ultraschall Med. 2007 Feb;28(1):45-51
references: 17304412
references: Radiology. 2003 Feb;226(2):411-6
references: 12563134
references: BMC Nephrol. 2003 Feb 06;4:2
references: 12622875
references: Kidney Int. 2006 Feb;69(3):580-7
references: 16407882
references: J Vasc Surg. 2009 Jan;49(1):148-55, 155.e1-3; discussion 155
references: 18951751
references: J Hypertens. 2005 Oct;23(10):1795-7
references: 16148600
references: Radiographics. 2000 Sep-Oct;20(5):1355-68; discussion 1368-72
references: 10992024
references: J Vasc Surg. 2007 Oct;46(4):731-7
references: 17764871
references: J Vasc Surg. 2008 Aug;48(2):323-8
references: 18644479
references: Cardiovasc Ultrasound. 2006 Jan 25;4:4
references: 16436206
references: Ann Intern Med. 1995 Jun 1;122(11):833-8
references: 7741367
references: Ultrasound Q. 2007 Dec;23(4):279-92
references: 18090838
references: Nephron Clin Pract. 2007;105(2):c84-9
references: 17164562
references: J Clin Ultrasound. 2003 Sep;31(7):346-51
references: 12923878
references: Radiol Med. 2008 Mar;113(2):242-8
references: 18386125
references: Radiology. 1992 Aug;184(2):479-85
references: 1620852
references: J Clin Hypertens (Greenwich). 2003 May-Jun;5(3):210-8
references: 12826784
references: Semin Nucl Med. 2006 Jan;36(1):3-15
references: 16356793
references: Clin Nephrol. 2000 May;53(5):333-43
references: 11305806
references: Eur Radiol. 2001;11(10):1902-15
references: 11702122
references: J Negat Results Biomed. 2004 Sep 20;3:3
references: 15380022
references: J Am Soc Nephrol. 2002 Nov;13 Suppl 3:S184-6
references: 12466311
references: J Ultrasound Med. 2005 Dec;24(12):1641-7
references: 16301720
references: Kidney Int Suppl. 1999 Jul;71:S106-9
references: 10412750
references: Semin Nephrol. 2000 Sep;20(5):445-9
references: 11022897
references: J Ultrasound Med. 2002 Apr;21(4):431-41
references: 11934100
references: Radiology. 2000 Mar;214(3):739-46
references: 10715040
references: Ultrasound Med Biol. 2000 Jan;26(1):41-7
references: 10687791
references: Vasc Endovascular Surg. 2003 Nov-Dec;37(6):429-36
references: 14671698
references: J Am Soc Nephrol. 2001 Oct;12(10):2190-2196
references: 11562420
references: J Hypertens. 2009 Aug;27(8):1690-6
references: 19542896
references: N Engl J Med. 2001 Feb 8;344(6):410-7
references: 11172177
references: Clin Nephrol. 2009 Jun;71(6):680-6
references: 19473637
references: Rev Cardiovasc Med. 2004 Fall;5(4):204-15
references: 15580159
references: Eur Radiol. 2004 Oct;14 Suppl 8:P104-9
references: 15700338
references: J Ultrasound Med. 2003 May;22(5):433-9; quiz 440-2
references: 12751854
references: Int Angiol. 2003 Jun;22(2):101-15
references: 12865875
references: J Ultrasound Med. 2006 Jun;25(6):735-42; quiz 743-4
references: 16731890
references: AJR Am J Roentgenol. 2007 Mar;188(3):798-811
references: 17312071
references: N Engl J Med. 2001 Feb 8;344(6):431-42
references: 11172181
references: J Ultrasound. 2008 Jun;11(2):55-73
references: 23396958
references: Nephron Clin Pract. 2006;103(2):c24-8
references: 16543752
references: J Ultrasound Med. 2006 Mar;25(3):293-8
references: 16495488
references: Cardiovasc Intervent Radiol. 1999 Nov-Dec;22(6):475-80
references: 10556406
references: Radiology. 1992 Aug;184(2):487-92
references: 1620853
references: Kidney Int. 1991 Jun;39(6):1232-9
references: 1895675
references: Saudi J Kidney Dis Transpl. 2002 Jul-Sep;13(3):311-9
references: 18209426
references: AJR Am J Roentgenol. 2000 Mar;174(3):629-34
references: 10701600
references: Kidney Int. 2005 Apr;67(4):1515-20
references: 15780105