[Diagnosis of renovascular disease by heart catheterization]

Atherosclerotic renovascular disease is a common entity, particularly in persons older than 50 years of age and especially in those patients with other evidence of atherosclerotic vascular disease. The illness clearly progresses in some patients, and progression rate appears to be highly variable. Taken into account the apparent high prevalence of renovascular disease in older persons, it is possible that this disorder be the cause of end stage renal disease in 5% to 15% of patients currently entering the dialysis program each year. Surgery and percutaneous angioplasty can both improve renal function in patients with renal artery stenosis. We describe a patient in whom the detection of renovascular disease was made accidentally at the time of coronary arteriography. He presented an acute renal failure after use of angiotensin-converting enzyme inhibitors and/or contrast media associated nephrotoxicity, and was treated with percutaneous transluminal balloon angioplasty and had a successful outcome.