ABDOMINAL - RENAL

renal arterial supply

• aorta

• main renal artery

• segmental

• interlobar

• arcuate

• intralobar

• afferent arterioles

the lra originates from the _____ aspect of the aorta

posterolateral

the rra originates from the _____ aspect of the aorta

anterolateral

the rra courses _____ to the ivc to reach the kidney

posterior

renal arteries normally course _____ to the renal veins

posterior

_____% of patients have duplicated renal arteries

30

how can lumbar arteries be differentiated from accessory renal arteries

they are very high resistance and renal arteries are not

low resistance flow with a low ri is considered _____ for the renals

normal

what ri is considered abnormal for the renal arteries

over .7

parenchymal ri values under .5 can indicate

proximal renal artery stenosis and renal ischemia

a difference in length of greater than _____ cm between the kidneys can mean renal disease or ras

2

serum BUN and creatinine levels will be _____ with decreased renal perfusion/function

increased

how does renovascular htn work

• kidney receives less blood flow due to arterial stenosis

• kidneys perceive this as body having an overall low blood pressure

• renal response is the angio-tensin aldosterone response to raise pressure to increase flow to the kidneys, leading to systemic htn

ras is most commonly caused by

atherosclerosis

second most common cause of ras

fibromuscular dysplasia

fibromuscular dysplasia most commonly affects what part of the renal arteries

mid-distal

gold standard in diagnosis of renal stenosis

angiography

a kidney length of under _____ cm is considered abnormal

9

how is edr calculated and what does it evaluate

edv/psv, evaluates parenchymal resistance

when is the renal/aortic ratio invalid in patients

when they have aaa or aortic stenosis, which can artificially reduce velocities

increased resistance in the renal arteries can indicate

distal stenosis or kidney disease

stenosis causes the _____ to disappear, making the waveform more rounded

early systolic peak

renal artery occlusion will cause the echogenicity of the kidney to

increase

renal artery occlusion will cause the contralateral kidney to _____ in size

increase

renal artery occlusion will cause the affected kidney to _____ in size

decrease

renal transplant is the gold standard for patients with

end stage renal disease

most common site for renal transplant

right iliac fossa

most common sites for renal arterial and venous anastomosis in renal transplant

external iliac artery and vein (internals are used as an alternative)

how to calculate velocity ratio for transplanted kidney

psv of main renal artery of allograft / native iliac artery psv

#1 acute cause of allograft failure

acute tubular necrosis

causes of allograft failure

• infection

• vascular thrombosis/stenosis

• rejection

• drug toxicity

signs of allograft failure

• oliguria

• elevated BUN

• elevated creatinine

acute vs chronic rejection

• acute is within 1-3 weeks

• chronic starts after 3 months, is progressive decrease