Kidney artery stenosis

Patients should only be screened for renal artery stenosis when they have an increased likelihood for developing stenosis and relevant clinical problems. Good screening methods include color Doppler, computed tomography (angio-CT) and magnetic resonance imaging (MRI). All methods are dependent on the examiner and sonography is preferred in the guidelines due to its lower side effects and costs. The correction of renal artery stenosis should not be made depending only on the degree of stenosis as a large number of randomized studies comparing angioplasty with optimal medicinal treatment could not show any superiority; however, suitable candidates for angioplasty are patients with a degree of stenosis of 60% or more, poorly controlled blood pressure and deteriorating kidney function as well as patients with sudden pulmonary edema or recurrent acute heart failure. All patients should receive blood pressure control with an inhibitor of the renin-angiotensin-aldosterone system (RAAS), a statin and antiplatelet treatment, practice nicotine abstinence, perform physical activity and maintain a healthy diet.