What is the role of noninvasive renal imaging or invasive renal angiography in the evaluation of hypertension (high blood pressure)?

Updated: Feb 22, 2019
  • Author: Matthew R Alexander, MD, PhD; Chief Editor: Eric H Yang, MD  more...
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Answer

If the patient’s history suggests renal artery stenosis and if a corrective procedure is considered, further noninvasive radiologic investigations (eg, computed tomographic angiography [CTA], magnetic resonance angiography [MRA]) or invasive renal angiography can be performed. [5, 6, 67] Concern over the risk of nephrogenic systemic fibrosis (NSF) due to gadolinium has reduced the use of MRA, particularly in patients with chronic kidney disease who have a glomerular filtration rate lower than 30 mL/min. This is a rare, debilitating, life-threatening disorder associated with gadolinium. CT or invasive angiography carries the risk of dye nephropathy.

For more information on NSF and contrast-induced nephropathy, see the US Food and Drug Administration (FDA) Web page Information on Gadolinium-Based Contrast Agents [68] and the American College of Radiology’s (ACR) Manual on Contrast Media (version 7).


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