Diagnosis of Hypertension due to Renal Arterial Stenosis

Publisher Website
Google Scholar
Abstract
Dehydrated-hydrated intravenous pyelography is the simplest, most generally applicable, and possibly most specific of the screening procedures. It is less hazardous and less uncomfortable for the patient than all but hippuran I131 renography. If the results are definitely negative, we believe we can dispense with further tests. If a question remains, this test can be followed by: Comparative usodium/ucreatinine ratio Preceded by a provocative infusion of hyper-tonic saline solution. The provocative infusion greatly exaggerates this ratio and so increases the sensitivity of the test. Comparative Usodium/Ucreatinine ratio alone in those patients in whom a provocative infusion of hypertonic saline solution seems inadvisable. Full inulin-PAH differential clearance combined with a provocative infusion of hypertonic saline solution if it is considered mandatory to establish separately the function of each kidney. Hippuran I131 renogram showing a normal result with bilaterally equal renograms will almost always exclude renal arterial stenosis. An abnormal result requires the addition of more definitive procedures, since the renogram evidently cannot distinguish between renal parenchymal and renal arterial disease. Its simplicity commends it, but the expense of the equipment and its lack of specificity make it less practical.