Renal artery stenosis: evaluation with colour duplex ultrasonography

Riehl, J; Schmitt, Heinz‐J.; Bongartz, D; Bergmann, Deborah; Sieberth, H. G.

doi:10.1093/ndt/12.8.1608

Cited by 71 publications

(45 citation statements)

References 4 publications

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“…Intrarenal Doppler parameters such as decreased flow velocity, low RI (<0.50) and PI values, decreased acceleration (<3 m/s 2 ) and increased acceleration time (>70 m/s) are also considered in renal artery stenosis (Bude and Rubin 1995). Comparison of intrarenal RI and PI values on the side with pathology with the contralateral kidney also improves diagnostic success in unilateral renal artery stenosis (Krumme et al, 1996;Riehl et al, 1997). Another study suggested that the normal early systolic peak that should normally be observed disappears (Stavros et al, 1992).…”

Section: Wwwintechopencommentioning

confidence: 99%

The Evaluation of Renal Hemodynamics with Doppler Ultrasonography

Kaya¹

2012

Hemodynamics - New Diagnostic and Therapeutic Approaches

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Section: Wwwintechopencommentioning

confidence: 99%

The Evaluation of Renal Hemodynamics with Doppler Ultrasonography

Kaya¹

2012

Hemodynamics - New Diagnostic and Therapeutic Approaches

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“…None of the 325 patients that were included in this study had an hilar acceleration time Ͼ100 mm/s or had evidence of kidney atrophy (Ͻ9 cm in length), parameters that are suggestive of renal artery stenosis Ͻ60% (10,11). Furthermore, no patients with renal insufficiency were included in this study if they had a mean resistance index value Ͻ0.45, a value associated with bilateral renal artery stenosis, or a difference in resistance index values Ͼ8% between the two different kidneys, a value associated with the presence of unilateral renal artery stenosis (12). We also assessed the effects on resistance index values of a Ͼ25% difference in kidney size (estimated by length ϫ width ϫ 0.5).…”

Section: Measurement Of Intrarenal Arterial Resistance Indexmentioning

confidence: 99%

“…However, patients with known renal artery stenosis were excluded, and we accounted for Doppler intrarenal indexes that have been previously reported to be associated with the presence of hemodynamically significant renal artery stenosis (12). Also, eliminating patients with asymmetrical kidney size (Ͼ25%) did not alter the finding that resistance index values were elevated to a similar extent in subjects with renal insufficiency regardless of albuminuric status.…”

Section: The Effect Of Ras Inhibition On Intrarenal Resistance Indexmentioning

confidence: 99%

Is Nonalbuminuric Renal Insufficiency in Type 2 Diabetes Related to an Increase in Intrarenal Vascular Disease?

et al. 2006

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OBJECTIVE -To investigate the role of intrarenal vascular disease in the pathogenesis of nonalbuminuric renal insufficiency in type 2 diabetes.RESEARCH DESIGN AND METHODS -We studied 325 unselected clinic patients who had sufficient clinical and biochemical information to calculate an estimated glomerular filtration rate (eGFR) using the Modified Diet in Renal Disease six-variable formula, at least two estimations of urinary albumin excretion rates (AER), and a renal duplex scan to estimate the resistance index of the interlobar renal arteries. The resistance index, measured as part of a complications surveillance program, was compared in patients with an eGFR Ͻ or Ն60 ml/min per 1.73 m 2 who were further stratified into normo-(AER Ͻ20), micro-(20 -200), or macroalbuminuria (Ͼ 200 g/min) categories.RESULTS -Patients with an eGFR Ͻ60 ml/min per 1.73 m 2 had a higher resistance index of the renal interlobar arteries compared with patients with an eGFR Ն60 ml/min per 1.73 m 2 . However, the resistance index was elevated to a similar extent in patients with an eGFR Ͻ60 ml/min per 1.73 m 2 regardless of albuminuric status (normo-0.74 Ϯ 0.01, micro-0.73 Ϯ 0.01, and macroalbuminuria resistance index 0.75 Ϯ 0.11). Multiple regression analysis revealed that increased age (P Ͻ 0.0001), elevated BMI (P ϭ 0.0001), decreased eGFR (P Ͻ 0.01), and decreased diastolic blood pressure (P Ͻ 0.01), but not an increased AER, were independently associated with an elevated resistance index in patients with impaired renal function.CONCLUSIONS -Subjects with type 2 diabetes and reduced glomerular filtration rate had similar degrees of intrarenal vascular disease, as measured by the intrarenal arterial resistance index, regardless of their AER status. The pathological mechanisms that determine the relationship between impaired renal function and AER status in subjects with type 2 diabetes remain to be elucidated. Diabetes Care 29:1560 -1566, 2006T raditionally, microvascular disease resulting in a glomerulopathy and an increase in albumin excretion rate (AER) is believed to be the only significant mechanism by which diabetic renal disease develops. However, recent results have challenged the concept that a decline in renal function in patients with diabetes is always accompanied by an increased AER. Results from our group (1,2) and from the Third National Health and Nutrition Survey (NHANES III) (3,4) have suggested that the finding of nonalbuminuric renal insufficiency is not an uncommon discovery for subjects with diabetes, especially those with type 2 diabetes.The structural basis of nonalbuminuric renal insufficiency in type 2 diabetes remains to be elucidated. However, the use of techniques such as duplex Doppler ultrasound allows for the rapid, noninvasive evaluation of the intrarenal vasculature (5). In particular, the presence of intrarenal vascular disease can be documented by the use of established methods such as the calculation of the resistance index (5,6). Intrarenal arteriosclerosis, as opposed to other forms of renal dama...

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“…Sensitivity of up to 92% and specificity of up to 95% for detection of severe RAS (greater than 70%) have been reported. [29][30][31] Generally, it was found that moderate renal artery narrowing (50-70%), did not produce convincing Doppler waveform changes in the intra-renal vessels. These studies also found that peripheral renal Doppler studies could not always reliably distinguish severe stenosis from complete occlusion.…”

Section: Ultrasoundmentioning

confidence: 96%

Diagnostic imaging of renal artery stenosis

Aitchison

Page

1999

J Hum Hypertens

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Many different imaging modalities and techniques have been used in the past for the diagnosis of renal artery stenosis. The ideal accurate, non-invasive and inexpensive diagnostic test has yet to be found but there have been promising developments during the last few years. In this review we consider in detail the use of the following tests for the diagnosis of renal artery stenosis; intravenous urography, B Mode ultrasound, Doppler ultrasound, renal scintigraphy with angiotensin-converting

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Renal artery stenosis: evaluation with colour duplex ultrasonography

Abstract: Colour duplex US with calculation of the RI and delta RI of intrarenal arteries is a valuable non-invasive test assessing the haemodynamic effects of a RAS. Low costs and safety support the use of the Doppler technique in screening for renovascular disease.

Cited by 71 publications

References 4 publications

The Evaluation of Renal Hemodynamics with Doppler Ultrasonography

The Evaluation of Renal Hemodynamics with Doppler Ultrasonography

Is Nonalbuminuric Renal Insufficiency in Type 2 Diabetes Related to an Increase in Intrarenal Vascular Disease?

Diagnostic imaging of renal artery stenosis

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