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renovascular disease

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This condition may result in secondary hypertension and secondary hyperaldosteronism. Other possible features include:

  • coexistant cerebrovascular, cardiovascular or peripheral vascular disease
  • deterioration of renal function following treatment with ACE inhibitor
  • abdominal bruit; signs of coexistant vascular disease e.g. carotid or femoral bruit; absent peripheral pulses

A small kidney will be seen on intravenous urography on the affected side with a delayed and persistent nephrogram.

In consideration of computed tomographic angiography and magnetic resonance angiography (MRA) in comparison to digital subtraction angiography (DSA) in diagnosis of renal artery stenosis (1):

  • computed tomographic angiography and MRA are not reproducible or sensitive enough to rule out renal artery stenosis in hypertensive patients
  • DSA is the diagnostic method of choice

Reference:

  1. Vasbinder GB et al. Accuracy of computed tomographic angiography and magnetic resonace angiography for diagnosis renal artery stenosis. Ann Intern Med 2004;141:674-82

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