Question

In a patient with suspected renal artery stenosis or renal parenchymal disease as a potential cause of hypertension, what diagnostic tests or investigations should be ordered for further evaluation?

Answer 1

For evaluating suspected renal artery stenosis or parenchymal disease in hypertensive patients, an abdominal ultrasound, serum creatinine levels, CT scan, and nuclear medicine scans like MAG3 and DMSA are commonly used diagnostic tests.

Step-by-step explanation:

For a patient with suspected renal artery stenosis or renal parenchymal disease that may be causing hypertension, there are several diagnostic tests and investigations that can be ordered for further evaluation. These include an abdominal ultrasound to examine kidney size and rule out obstruction, as well as a serum creatinine test to assess kidney function. If the ultrasound is inconclusive, a computed tomography (CT) scan, which is the gold-standard test for kidney stone detection, may be conducted. Additional evaluations may consist of a nuclear medicine MAG3 scan and DMSA scans to confirm kidney blood flows and relative function of the kidneys. Furthermore, an electrocardiogram and cardiac stress testing can help assess any cardiac contributions to the hypertension, although these are not directly assessing kidney function.