Fig. 2.

Diagnostic algorithm for identification and treat renovascular hypertension (RVH). As no single test is sensitive and specific enough to detect and ruled out RVH, a comprehensive assessment based on biochemical (↓ K⁺, ↑ renin, ↑ plasma aldosterone concentration) and instrumental tests (Duplex sonography and renal post-captopril scintigraphy) is necessary. Imaging by angio-CT or angio-MR plays a key role to assess the localization of stenosis and multivessel involvement, and to plan revascularization, by angioplasty in FMD-RVH and angioplasty + stenting in case of ATS-RVH. RVH renovascular hypertension, FMD fibromuscular dysplasia, CT computed tomography, MR magnetic resonance, PTRA percutaneous transluminal renal angioplasty, BP blood pressure