RENAL ARTERY STENOSIS
RENAL ARTERY STENOSIS Also known as Reno vascular hypertension It is the narrowing of one or both of the renal arteries ETIOLOGY: most common cause - Atherosclerosis fibromuscular dysplasia (FMD) - (young females) Takayasu arteritis - Asian population (pulseless disease) CLINICAL FEATURE: Refractory hypertension sudden rise BP in preexisting HTN patient flash pulmonary edema presence of abdominal bruit (systole + diastole) check peripheral pulses poly arteritis nodosa - not cause of renal artery stenosis but can lead to Aneurysm formation WORKUP: USG - Asymmetric kidneys size - Not responding to anti hypertensive medication Doppler - best screening test CT Angiography Magnetic Resonant Angiography (MRA) - expensive ↓↓↓ - false positive results - due to turbulent flow - Gadolinium - cause nephrogenic system fibrosis IOC - Renal angiography (invasive test)(gold standard) DTPA scan before and after giving ACE inhibitor (Capt...