Renal artery stenosis differential diagnosis: Difference between revisions
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{{Renal artery stenosis}} | {{Renal artery stenosis}} | ||
{{CMG}} | {{CMG}} | ||
==Overview== | |||
Renal artery stenosis should be differentiated from [[essential hypertension]] and other causes of [[secondary hypertension]]. | |||
==Differentiating [Disease name] from other Diseases== | |||
[Disease name] must be differentiated from other diseases that cause [clinical feature 1], [clinical feature 2], and [clinical feature 3], such as [differential dx1], [differential dx2], and [differential dx3]. | |||
OR | |||
[Disease name] must be differentiated from [differential dx1], [differential dx2], and [differential dx3]. | |||
OR | |||
As [disease name] manifests in a variety of clinical forms, differentiation must be established in accordance with the particular subtype. [Subtype name 1] must be differentiated from other diseases that cause [clinical feature 1], such as [differential dx1] and [differential dx2]. In contrast, [subtype name 2] must be differentiated from other diseases that cause [clinical feature 2], such as [differential dx3] and [differential dx4]. | |||
===Differentiating [disease name] from other diseases on the basis of [symptom 1], [symptom 2], and [symptom 3]=== | |||
On the basis [symptom 1], [symptom 2], and [symptom 3], [disease name] must be differentiated from [disease 1], [disease 2], [disease 3], [disease 4], [disease 5], and [disease 6]. | |||
{| | |||
|- style="background: #4479BA; color: #FFFFFF; text-align: center;" | |||
! rowspan="4" style="background: #4479BA; color: #FFFFFF; text-align: center;|Diseases | |||
| colspan="6" rowspan="1" style="background: #4479BA; color: #FFFFFF; text-align: center;|'''Clinical manifestations''' | |||
! colspan="7" rowspan="2" style="background: #4479BA; color: #FFFFFF; text-align: center;|Para-clinical findings | |||
| colspan="1" rowspan="4" style="background: #4479BA; color: #FFFFFF; text-align: center;|'''Gold standard''' | |||
! rowspan="4" style="background: #4479BA; color: #FFFFFF; text-align: center;|Additional findings | |||
|- | |||
| colspan="3" rowspan="2" style="background: #4479BA; color: #FFFFFF; text-align: center;|'''Symptoms''' | |||
! colspan="3" rowspan="2" style="background: #4479BA; color: #FFFFFF; text-align: center;|Physical examination | |||
|- | |||
! colspan="3" style="background: #4479BA; color: #FFFFFF; text-align: center;|Lab Findings | |||
! colspan="3" style="background: #4479BA; color: #FFFFFF; text-align: center;|Imaging | |||
! rowspan="2" style="background: #4479BA; color: #FFFFFF; text-align: center;|Histopathology | |||
|- | |||
! style="background: #4479BA; color: #FFFFFF; text-align: center;|Symptom 1 | |||
! colspan="1" rowspan="1" style="background: #4479BA; color: #FFFFFF; text-align: center;|Symptom 2 | |||
! style="background: #4479BA; color: #FFFFFF; text-align: center;|Symptom 3 | |||
! style="background: #4479BA; color: #FFFFFF; text-align: center;|Physical exam 1 | |||
! colspan="1" rowspan="1" style="background: #4479BA; color: #FFFFFF; text-align: center;|Physical exam 2 | |||
! style="background: #4479BA; color: #FFFFFF; text-align: center;|Physical exam 3 | |||
! style="background: #4479BA; color: #FFFFFF; text-align: center;|Lab 1 | |||
! style="background: #4479BA; color: #FFFFFF; text-align: center;|Lab 2 | |||
! style="background: #4479BA; color: #FFFFFF; text-align: center;|Lab 3 | |||
! style="background: #4479BA; color: #FFFFFF; text-align: center;|Imaging 1 | |||
! style="background: #4479BA; color: #FFFFFF; text-align: center;|Imaging 2 | |||
! style="background: #4479BA; color: #FFFFFF; text-align: center;|Imaging 3 | |||
|- | |||
| style="background: #DCDCDC; padding: 5px; text-align: center;" |Differential Diagnosis 1 | |||
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|- | |||
| style="background: #DCDCDC; padding: 5px; text-align: center;" |Differential Diagnosis 2 | |||
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|- | |||
| style="background: #DCDCDC; padding: 5px; text-align: center;" |Differential Diagnosis 3 | |||
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|- style="background: #4479BA; color: #FFFFFF; text-align: center;" | |||
!Diseases | |||
!Symptom 1 | |||
! colspan="1" rowspan="1" |Symptom 2 | |||
!Symptom 3 | |||
!Physical exam 1 | |||
! colspan="1" rowspan="1" |Physical exam 2 | |||
!Physical exam 3 | |||
!Lab 1 | |||
!Lab 2 | |||
!Lab 3 | |||
!Imaging 1 | |||
!Imaging 2 | |||
!Imaging 3 | |||
!Histopathology | |||
|'''Gold standard''' | |||
!Additional findings | |||
|- | |||
| style="background: #DCDCDC; padding: 5px; text-align: center;" |Differential Diagnosis 4 | |||
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|- | |||
| style="background: #DCDCDC; padding: 5px; text-align: center;" |Differential Diagnosis 5 | |||
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|- | |||
| style="background: #DCDCDC; padding: 5px; text-align: center;" |Differential Diagnosis 6 | |||
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|} | |||
==Differentiating Renal Artery Stenosis from Essential Hypertension== | ==Differentiating Renal Artery Stenosis from Essential Hypertension== |
Latest revision as of 13:06, 2 November 2020
Renal artery stenosis Microchapters |
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Treatment |
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Renal artery stenosis differential diagnosis On the Web |
American Roentgen Ray Society Images of Renal artery stenosis differential diagnosis |
Risk calculators and risk factors for Renal artery stenosis differential diagnosis |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Renal artery stenosis should be differentiated from essential hypertension and other causes of secondary hypertension.
Differentiating [Disease name] from other Diseases
[Disease name] must be differentiated from other diseases that cause [clinical feature 1], [clinical feature 2], and [clinical feature 3], such as [differential dx1], [differential dx2], and [differential dx3].
OR
[Disease name] must be differentiated from [differential dx1], [differential dx2], and [differential dx3].
OR
As [disease name] manifests in a variety of clinical forms, differentiation must be established in accordance with the particular subtype. [Subtype name 1] must be differentiated from other diseases that cause [clinical feature 1], such as [differential dx1] and [differential dx2]. In contrast, [subtype name 2] must be differentiated from other diseases that cause [clinical feature 2], such as [differential dx3] and [differential dx4].
Differentiating [disease name] from other diseases on the basis of [symptom 1], [symptom 2], and [symptom 3]
On the basis [symptom 1], [symptom 2], and [symptom 3], [disease name] must be differentiated from [disease 1], [disease 2], [disease 3], [disease 4], [disease 5], and [disease 6].
Diseases | Clinical manifestations | Para-clinical findings | Gold standard | Additional findings | |||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Symptoms | Physical examination | ||||||||||||||
Lab Findings | Imaging | Histopathology | |||||||||||||
Symptom 1 | Symptom 2 | Symptom 3 | Physical exam 1 | Physical exam 2 | Physical exam 3 | Lab 1 | Lab 2 | Lab 3 | Imaging 1 | Imaging 2 | Imaging 3 | ||||
Differential Diagnosis 1 | |||||||||||||||
Differential Diagnosis 2 | |||||||||||||||
Differential Diagnosis 3 | |||||||||||||||
Diseases | Symptom 1 | Symptom 2 | Symptom 3 | Physical exam 1 | Physical exam 2 | Physical exam 3 | Lab 1 | Lab 2 | Lab 3 | Imaging 1 | Imaging 2 | Imaging 3 | Histopathology | Gold standard | Additional findings |
Differential Diagnosis 4 | |||||||||||||||
Differential Diagnosis 5 | |||||||||||||||
Differential Diagnosis 6 |
Differentiating Renal Artery Stenosis from Essential Hypertension
Hypertensive patients afflicted with renal artery stenosis often have one or more of the following characteristics:
- Onset of hypertension before the age of 30 years
- Onset of severe hypertension (SBP ≥180 mm Hg and/or DBP ≥120 mm Hg) after the age of 55 years
- New azotemia or worsening renal function after administration of an ACE inhibitor or ARB agent
- Unexplained atrophic kidney or size discrepancy between kidneys of greater than 1.5 cm
- Sudden, unexplained pulmonary edema
- Accelerated hypertension (sudden and persistent worsening of previously controlled hypertension)
- Resistant hypertension (failure to achieve goal blood pressure in patients who are adhering to full doses of an appropriate 3-drug regimen that includes a diuretic)
- Malignant hypertension (hypertension with coexistent evidence of acute end-organ damage, i.e., acute renal failure, acutely decompensated congestive heart failure, new visual or neurological disturbance, and/or advanced [grade III to IV] retinopathy)
- Unexplained renal failure in the absence of proteinuria or an abnormal urine sediment
- Multivessel coronary artery disease
- Unexplained congestive heart failure
- Refractory angina
Noninvasive diagnostic studies such as Duplex ultrasound, CT angiography, or magnetic resonance angiography are indicated in the presence of any above-mentioned conditions. If the results of noninvasive screening are inconclusive, catheter angiography may be considered.[1][2]
References
- ↑ Hirsch AT, Haskal ZJ, Hertzer NR, Bakal CW, Creager MA, Halperin JL; et al. (2006). "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. 113 (11): e463–654. doi:10.1161/CIRCULATIONAHA.106.174526. PMID 16549646.
- ↑ Rooke TW, Hirsch AT, Misra S, Sidawy AN, Beckman JA, Findeiss LK; et al. (2011). "2011 ACCF/AHA Focused Update of the Guideline for the Management of Patients With Peripheral Artery Disease (updating the 2005 guideline): a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines". J Am Coll Cardiol. 58 (19): 2020–45. doi:10.1016/j.jacc.2011.08.023. PMID 21963765.