Hypertension and atherosclerotic renal artery stenosis: diagnostic approach.

Atherosclerotic renovascular disease needs noninvasive diagnostic tools to apply to patients having clinical characteristics that can suggest its presence. Color Doppler ultrasonography is a noninvasive, inexpensive diagnostic procedure that is capable, in an experienced hand, of accurately screening for renovascular disease. Magnetic resonance angiography and spiral computed tomography angiography play an ancillary role in detecting atheromatous renovascular disease. Captopril-enhanced renography and scintigraphy and the resistive index at Doppler sonography may be very useful in patients with renal artery stenosis for predicting the response to revascularization.