Renal artery stenosis resident survival guide: Difference between revisions
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<tr class="v-firstrow"><th>Scenario</th><th>Level of evidence</th></tr> | <tr class="v-firstrow"><th>Scenario</th><th>Level of evidence</th></tr> | ||
<tr><td>'''1.'''Onset of hypertension before the age of 30 years or severe hypertension after the age of 55</td><td>Class I; LOE B</td></tr> | <tr><td>'''1.'''Onset of hypertension before the age of 30 years or severe hypertension after the age of 55</td><td>Class I; LOE B</td></tr> | ||
<tr><td>2. Accelerated, resistant, or malignant hypertension</td><td>Class I; LOE C</td></tr> | <tr><td>'''2.''' Accelerated, resistant, or malignant hypertension</td><td>Class I; LOE C</td></tr> | ||
<tr><td>3. Development of new azotemia or worsening renal function after administration of an ACE inhibitor or ARB agent</td><td>Class I; LOE B</td></tr> | <tr><td>'''3.''' Development of new azotemia or worsening renal function after administration of an ACE inhibitor or ARB agent</td><td>Class I; LOE B</td></tr> | ||
<tr><td>4. Unexplained atrophic kidney or size discrepancy between kidneys of greater than 1.5 cm</td><td>Class I; LOE B</td></tr> | <tr><td>'''4.''' Unexplained atrophic kidney or size discrepancy between kidneys of greater than 1.5 cm</td><td>Class I; LOE B</td></tr> | ||
<tr><td>5. Sudden, unexplained pulmonary edema</td><td>Class I; LOE B</td></tr> | <tr><td>'''5.''' Sudden, unexplained pulmonary edema</td><td>Class I; LOE B</td></tr> | ||
<tr><td>6. Unexplained renal dysfunction, including individuals starting renal replacement therapy</td><td>Class IIa; LOE B</td></tr> | <tr><td>'''6.''' Unexplained renal dysfunction, including individuals starting renal replacement therapy</td><td>Class IIa; LOE B</td></tr> | ||
<tr><td>7. Multi-vessel coronary artery disease</td><td>Class IIb; LOE B</td></tr> | <tr><td>'''7.''' Multi-vessel coronary artery disease</td><td>Class IIb; LOE B</td></tr> | ||
<tr><td>8. Unexplained congestive heart failure</td><td>Class IIb; LOE C</td></tr> | <tr><td>'''8.''' Unexplained congestive heart failure</td><td>Class IIb; LOE C</td></tr> | ||
<tr><td>9. Refractory angina</td><td>Class IIb; LOE C</td></tr> | <tr><td>'''9.''' Refractory angina</td><td>Class IIb; LOE C</td></tr> | ||
</table>}} | </table>}} | ||
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{{familytree | B01 | | B02 | B01=<div style="height: 1em; width: 25em; padding:1em;">'''Noninvasive Imaging | {{familytree | B01 | | B02 | B01=<div style="height: 1em; width: 25em; padding:1em;">'''Noninvasive Imaging''' | ||
</div>| B02= <div style="height: 1em; width: 25em; padding:1em;">'''Invasive Imaging''' | </div>| B02= <div style="height: 1em; width: 25em; padding:1em;">'''Invasive Imaging''' | ||
</div>}} | |||
{{familytree | |!| | | |!| | }} | {{familytree | |!| | | |!| | }} | ||
{{familytree | C01 | | C02 | C01= <div style="float: left; text-align: left; height: 3em; width: 25em; padding:1em;">❑ | {{familytree | C01 | | C02 | C01= <div style="float: left; text-align: left; height: 3em; width: 25em; padding:1em;">❑ Duplex ultrasound | ||
❑ Gadolinium enhanced MRA | |||
❑ CT angiography </div>| C02= <div style="float: left; text-align: left; height: 3em; width: 25em; padding:1em;">❑ Abdominal aortography to assess the renal arteries during coronary and peripheral angiography </div>}} | |||
{{familytree/end}} | {{familytree/end}} | ||
Revision as of 06:09, 6 January 2014
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Karol Gema Hernandez, M.D. [2]
Definition
This section provides a short and straight to the point definition of the disease or symptom in one sentence.
Causes
Life Threatening Causes
Life-threatening causes include conditions which may result in death or permanent disability within 24 hours if left untreated.
Common Causes
Clinical Clues to the Diagnosis of RAS
| ❑ Determine if one or more of the above is present | |||||||||||||||||||||||||||||||
| |||||||||||||||||||||||||||||||
| ❑Proceed to further diagnostic testing | |||||||||||||||||||||||||||||||
Noninvasive Imaging
| Invasive Imaging
| ||||||||||||||||||||||||||||||
❑ Duplex ultrasound
❑ Gadolinium enhanced MRA ❑ CT angiography | ❑ Abdominal aortography to assess the renal arteries during coronary and peripheral angiography | ||||||||||||||||||||||||||||||
Algorithm based on the 2012 ACCP evidence based clinical practice guidelines.[1]
References
- ↑ Linkins LA, Dans AL, Moores LK, Bona R, Davidson BL, Schulman S; et al. (2012). "Treatment and prevention of heparin-induced thrombocytopenia: Antithrombotic Therapy and Prevention of Thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines". Chest. 141 (2 Suppl): e495S–530S. doi:10.1378/chest.11-2303. PMC 3278058. PMID 22315270.