Renal artery stenosis (R.A.St.)
R.A.S. accounts for 1-2 % of all cases of hypertension.

Types: - Fibromuscular dysplasia young ♀
- Astheroscherotic type old age.
C/P:1- Sympt of hypertension.
Malignant H - abd. Bruit.
Fundus hypersensitive retinopathy.

Investig : 1- Rapid sequence IVP
ischaemic nephrogram
side = soft tissue
shadow of
( 1) (2) (3)

Dye is given & 3-4 films are taken in the 1st few minutes is a good screening test.
Sonar ischaemic kid. may be smaller .
Renal scan defect in perfusion.
Renal angiography (diagnostic).
Types :
A- Flush aortography.
B- Selective renal angio
catheter into renal artery . Catheter renal
C-digital subtraction angiography. Artery

5- Renal vein rennin it is
­ in ischaemic side.
Saralasin test (for durability). It
Q angiotensin so if bl.
pr. is decreased = surgical durability.

ttt :
1- medical ttt antihypertensive see CVS.
angioplasty renal artery dilated by balloon catheter.

Source: Internal Medicine Book of Dr.Osama Mahmoud (Ain Shams University)