Diagnosis of Renal Artery Stenosis: What is the Optimal Diagnostic Test?

Renal artery stenosis (RAS) is a common cause of hypertension and renal insufficiency, especially in the elderly population. There are several excellent diagnostic tests available to diagnose RAS. Renal artery duplex ultrasound, magnetic resonance angiography (MRA), and spiral CT angiography have been shown to have excellent sensitivity and specificity for diagnosing renal artery disease. What test is used as a first-line screening test depends on factors such as degree of renal insufficency, cost, and experience and expertise in one's institution.