Abstract
The color duplex examination of the renal arteries continues to create diagnostic uncertainty in the clinical environment, affecting its reputation as a screening test for renovascular hypertension. There are two key reasons for this. The first is continued uncertainty about the diagnostic criteria. This is largely a debate about extrarenal versus intrarenal evaluation. Extrarenal criteria is required if the examination is to be considered optimal; however, the role of the valuable data obtained in the intrarenal assessment requires ongoing consideration. Both methods are described, and an integrated pragmatic approach to implementation is discussed. The second uncertainty arises because of the technical difficulties in visualizing the renal arteries throughout their length. Visualization is important in ensuring the accuracy of the examination. This paper looks at 10 sonographic windows through which the renal arteries can potentially be investigated. This review paper asserts that well-performed renal artery ultrasound is a valuable screening examination for a selected group of hypertensive patients.
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