eMedicine Specialties > Nephrology > Hypertension and the Kidney
Renovascular Hypertension: Multimedia
Updated: Sep 4, 2009
Multimedia
![]() | Media file 1: Magnetic resonance angiography (MRA) showing renal artery stenosis. Courtesy of Patricia Stoltzfus, MD, Chief of Interventional Radiology, West Virginia University. |
![]() | Media file 2: Proposed pathogenesis of renovascular hypertension. |
![]() | Media file 3: Diagnostic flowchart for the workup of renal artery stenosis. |
![]() | Media file 4: Angiogram showing bilateral renal artery stenosis. Courtesy of Department of Radiology, Henry Ford Hospital. |
![]() | Media file 5: After percutaneous transluminal angioplasty (right renal artery). Courtesy of Department of Radiology, Henry Ford Hospital. |
![]() | Media file 6: After percutaneous transluminal angioplasty and stent placement (left renal artery). Courtesy of Department of Radiology, Henry Ford Hospital. |
![]() | Media file 7: Close-up of the Palmaz stent. Courtesy of Department of Radiology, Henry Ford Hospital. |
More on Renovascular Hypertension |
| Overview: Renovascular Hypertension |
| Differential Diagnoses & Workup: Renovascular Hypertension |
| Treatment & Medication: Renovascular Hypertension |
| Follow-up: Renovascular Hypertension |
Multimedia: Renovascular Hypertension |
| References |
| Further Reading |
| « Previous Page |
References
Slanina M, Zizka J, Klzo L, et al. Contrast-enhanced MR angiography utilizing parallel acquisition techniques in renal artery stenosis detection. Eur J Radiol. Aug 9 2009;[Medline].
Nchimi A, Brisbois D, Materne R, et al. Free-breathing accelerated gadolinium-enhanced MR angiography in the diagnosis of renovascular disease. AJR Am J Roentgenol. Jun 2009;192(6):1531-7. [Medline].
Textor SC, Lerman L, McKusick M. The uncertain value of renal artery interventions: where are we now?. JACC Cardiovasc Interv. Mar 2009;2(3):175-82. [Medline].
Jensen G, Annerstedt M, Klingenstierna H, et al. Survival and quality of life after renal angioplasty: a five-year follow-up study. Scand J Urol Nephrol. 2009;43(3):236-41. [Medline].
Jokhi PP, Ramanathan K, Walsh S, et al. Experience of stenting for atherosclerotic renal artery stenosis in a cardiac catheterization laboratory: technical considerations and complications. Can J Cardiol. Aug 2009;25(8):e273-8. [Medline].
Leesar MA, Varma J, Shapira A, et al. Prediction of hypertension improvement after stenting of renal artery stenosis: comparative accuracy of translesional pressure gradients, intravascular ultrasound, and angiography. J Am Coll Cardiol. Jun 23 2009;53(25):2363-71. [Medline].
Aurell M, Jensen G. Treatment of renovascular hypertension. Nephron. 1997;75(4):373-83. [Medline].
Bloch MJ, Basile J. Clinical insights into the diagnosis and management of renovascular disease. An evidence-based review. Minerva Med. Oct 2004;95(5):357-73. [Medline].
Bloch MJ, Basile J. The diagnosis and management of renovascular disease: a primary care perspective. Part I. Making the diagnosis. J Clin Hypertens (Greenwich). May-Jun 2003;5(3):210-8. [Medline].
Bloch MJ, Basile J. The diagnosis and management of renovascular disease: a primary care perspective. Part II. Issues in management. J Clin Hypertens (Greenwich). Jul-Aug 2003;5(4):261-8. [Medline].
Canzanello VJ, Textor SC. Noninvasive diagnosis of renovascular disease. Mayo Clin Proc. Dec 1994;69(12):1172-81. [Medline].
Chobanian AV, Bakris GL, Black HR, Cushman WC, Green LA, Izzo JL Jr, et al. The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure: the JNC 7 report. JAMA. May 21 2003;289(19):2560-72. [Medline].
Conlon PJ, O'Riordan E, Kalra PA. New insights into the epidemiologic and clinical manifestations of atherosclerotic renovascular disease. Am J Kidney Dis. Apr 2000;35(4):573-87. [Medline].
Greco BA, Breyer JA. Atherosclerotic ischemic renal disease. Am J Kidney Dis. Feb 1997;29(2):167-87. [Medline].
Hacklander T, Mertens H, Stattaus J, Lurken M, Lerch H, Altenburg A, et al. Evaluation of renovascular hypertension: comparison of functional MRI and contrast-enhanced MRA with a routinely performed renal scintigraphy and DSA. J Comput Assist Tomogr. Nov-Dec 2004;28(6):823-31. [Medline].
Hirsch AT, Haskal ZJ, Hertzer NR, et al. ACC/AHA 2005 Practice Guidelines for the management of patients with peripheral arterial disease (lower extremity, renal, mesenteric, and abdominal aortic): a collaborative report from the American Association for Vascular Surgery/Society for Vascular Surgery, Society for Cardiovascular Angiography and Interventions, Society for Vascular Medicine and Biology, Society of Interventional Radiology, and the ACC/AHA Task Force on Practice Guidelines (Writing Committee to Develop Guidelines for the Management of Patients With Peripheral Arterial Disease): endorsed by the American Association of Cardiovascular and Pulmonary Rehabilitation; National Heart, Lung, and Blood Institute; Society for Vascular Nursing; TransAtlantic Inter-Society Consensus; and Vascular Disease Foundation. Circulation. Mar 21 2006;113(11):e463-654. [Medline]. [Full Text].
Kaplan NM. Renal vascular hypertension. In: Clinical Hypertension. 7th ed. Baltimore: Lippincott Williams & Wilkins; 1998:301-21.
Leung DA, Hoffmann U, Pfammatter T, Hany TF, Rainoni L, Hilfiker P, et al. Magnetic resonance angiography versus duplex sonography for diagnosing renovascular disease. Hypertension. Feb 1999;33(2):726-31. [Medline].
Ploth DW. Renovascular hypertension. In: Jacobson H, Striker G, Klahr S, eds. The Principles and Practice of Nephrology. 2nd ed. Philadelphia: BC Decker; 1995:379-86.
Rabbia C, Valpreda S. Duplex scan sonography of renal artery stenosis. Int Angiol. Jun 2003;22(2):101-15. [Medline].
Radermacher J, Haller H. The right diagnostic work-up: investigating renal and renovascular disorders. J Hypertens Suppl. May 2003;21 Suppl 2:S19-24. [Medline].
Safian RD, Textor SC. Renal-artery stenosis. N Engl J Med. Feb 8 2001;344(6):431-42. [Medline].
Soulez G, Oliva VL, Turpin S, Lambert R, Nicolet V, Therasse E. Imaging of renovascular hypertension: respective values of renal scintigraphy, renal Doppler US, and MR angiography. Radiographics. Sep-Oct 2000;20(5):1355-68; discussion 1368-72. [Medline].
Spitalewitz S, Reiser I. Renovascular hypertension: diagnosis and treatment. In: Oparil S, Weber MA, eds. Hypertension: A Companion to Brenner and Rector's The Kidney. Philadelphia: WB Saunders Co; 2000:662-74.
Textor SC. Pitfalls in imaging for renal artery stenosis. Ann Intern Med. Nov 2 2004;141(9):730-1. [Medline].
Tullis MJ, Caps MT, Zierler RE, Bergelin RO, Polissar N, Cantwell-Gab K, et al. Blood pressure, antihypertensive medication, and atherosclerotic renal artery stenosis. Am J Kidney Dis. Apr 1999;33(4):675-81. [Medline].
Vasbinder GB, Nelemans PJ, Kessels AG, Kroon AA, Maki JH, Leiner T, et al. Accuracy of computed tomographic angiography and magnetic resonance angiography for diagnosing renal artery stenosis. Ann Intern Med. Nov 2 2004;141(9):674-82; discussion 682. [Medline].
Working Group on Renovascular Hypertension. Detection, evaluation, and treatment of renovascular hypertension. Final report. Working Group on Renovascular Hypertension. Arch Intern Med. May 1987;147(5):820-9. [Medline].
Further Reading
Related eMedicine topics:
Angioplasty, Renal Artery
Fibromuscular Dysplasia
Hyperaldosteronism
Hypertension [Nephrology]
Hypertension [Ophthalmology]
Hypertension, Malignant
Renal Artery Stenosis
Renal Artery Stenosis/Renovascular Hypertension
Renovascular Hypertension, Surgical Treatment
Clinical guidelines:
ACC/AHA 2005 guidelines for the management of patients with peripheral arterial disease (lower extremity, renal, mesenteric, and abdominal aortic): a collaborative report from the American Association for Vascular Surgery/Society for Vascular Surgery, Society for Cardiovascular Angiography and Interventions, Society for Vascular Medicine and Biology, Society of Interventional Radiology, and the ACC/AHA Task Force on Practice Guidelines (Writing Committee to Develop Guidelines for the Management of Patients With Peripheral Arterial Disease). American College of Cardiology Foundation - Medical Specialty Society
American Heart Association - Professional Association
Society for Cardiovascular Angiography and Interventions - Medical Specialty Society
Society for Vascular Medicine and Biology - Medical Specialty Society
Society for Vascular Surgery - Medical Specialty Society
Society of Interventional Radiology - Medical Specialty Society. 2005. 191 pages. NGC:004740
ACR Appropriateness Criteria® renovascular hypertension. American College of Radiology - Medical Specialty Society. 1995 (revised 2007). 9 pages. NGC:006003
The fourth report on the diagnosis, evaluation, and treatment of high blood pressure in children and adolescents. National Heart, Lung, and Blood Institute (U.S.) - Federal Government Agency [U.S.]. 2004 Aug. 22 pages. NGC:003761
VHA/DoD clinical practice guideline for the diagnosis and management of hypertension in the primary care setting. Department of Defense - Federal Government Agency [U.S.]
Department of Veterans Affairs - Federal Government Agency [U.S.]
Veterans Health Administration - Federal Government Agency [U.S.]. 1999 May (revised 2004). 99 pages. NGC:004198
Clinical trials:
Benefits of Medical Therapy Plus Stenting for Renal Atherosclerotic Lesions (CORAL)
Comparison of Best Medical Treatment Versus Best Medical Treatment Plus Renal Artery Stenting (RADAR)
Keywords
renovascular hypertension, renal artery stenosis, renin-angiotensin-aldosterone, renin-angiotensin-aldosterone system, renin, angiotensin, aldosterone, renin angiotensin, fibromuscular dysplasia, renovascular occlusive disease, atherosclerotic renal artery disease, atherosclerotic renovascular disease, renal artery occlusive disease, RVHT, renal artery occlusion, renal arterial vascular disease, hyperreninemia, arterial occlusive disease, renal ischemia, angiotensin I, angiotensin II, secondary hypertension














Multimedia: Renovascular Hypertension