Zusammenfassung
Die arterielle Hypertonie ist eine sehr häufige Erkrankung und die Nierenarterienstenose, als eine zwar seltene, aber prinzipiell mögliche Ursache, ist potenziell heilbar. Daher ist der Untersuchungsauftrag: „Ausschluss Nierenarterienstenose” eine häufig gestellte Aufforderung an die Diagnostik im Rahmen der Abklärung der arteriellen Hypertonie. Hierfür ist ein geeignetes Screening-Verfahren notwendig, das nicht invasiv, effektiv und kostengünstig sein sollte. Es werden die Möglichkeiten und Grenzen der Sonographie bzw. der farbkodierten Duplexsonographie (FKDS) aufgearbeitet, wobei sich die FKDS mit der intrarenalen Dopplerflussanalyse als herausragendes Screening-Verfahren für den Nachweis bzw. Ausschluss von hämodynamisch relevanten Nierenarterienstenosen in der täglichen Praxis eignet. Allerdings bedarf auch diese Technik einer durchaus kritischen und differenzierten Anwendung unter Beachtung einiger wesentlicher extrarenaler Einflüsse.
Renal Artery Stenosis: Screening, Diagnostic and Therapeutic Options
Hypertension is a frequent disease and renal artery stenosis, as a potential cause of hypertension, can be cured. Therefore, we frequently need to exclude a renal artery stenosis in patients with hypertension in our daily routine. This calls for a screening procedure which is non-invasive, highly effective and not too expensive. This paper describes the advantages and limitations of colour Doppler ultrasound in diagnosing renal artery stenosis. Colour Doppler ultrasound with intrarenal Doppler analysis is an ideal tool in the screening for relevant renal artery stenosis in patients with hypertension. This technique, however, requires a careful approach and extrarenal abnormalities need to be considered.
Schlüsselwörter:
Nierenarterienstenose - Screening - Diagnose - Dopplersonographie - Übersicht
Key words:
Renal artery stenosis - Screening - Diagnosis - Ultrasound Doppler studies - Review
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Dr. med. Isabel Restrepo-Schaefer
Klinik für Innere Medizin Gastroenterologie, Stoffwechsel und Endokrinologie der Philipps Universität Marburg
Baldingerstraße 35 033 Marburg
