Renovascular disease and renal in sufficiency - Diagnosis and treatment

Renovascular disease as cause of end-stage renal disease has become more fr equent during the last decade. In order to minimize the need for dialysis t reatment non-invasive screening for the disease is needed. However, both ul trasonic duplex scanning and renal scintigraphy are not sufficient for dete ction of all stenosis. Furthermore, there is little data on non-invasive te sts in patients with renal insufficiency. Renal arteriography is the gold s tandard for detection of renovascular disease. One disadvantage is the risk of contrast-agent induced acute renal insufficiency. This problem can be a voided using carbon dioxide angiography. In the near future spiral computed tomography and magnetic resonance angiography may be alternatives for iden tifying patients with renovascular disease. Ischaemic nephropathy is potent ially curable. Percutaneous transluminal renal angioplasty is first line tr eatment in most cases. Intervention often results in improvement or preserv ation of renal function which is very important in order to avoid chronic d ialysis.