Appel RG, Bleyer AJ, Reavis S, Hanson KJ
Renovascular disease in older patients beginning renal replacement therapy

Kidney Int (Jul) 48:171-176 1995

Renal duplex sonography was used to identify renal artery stenosis (RAS) in 90 consecutive patients beginning dialysis (only half were completely evaluated for RAS). Ten of 45 patients had critical RAS (40% of white patients had critical RAS). Importantly, 11% of patients had bilateral disease, treatment of which could potentially improve renal function and obviate the need for dialysis. In centers with expertise in renal duplex ultrasonography, this is a useful noninvasive test to evaluate at-risk patients for the presence of ischemic nephropathy. Interestingly, the United States Renal Data System does not even have a category for renovascular disease as a cause of ESRD. (Paller)

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