Renal arteriography is a special x-ray of the blood vessels of the kidneys.
Renal arteriography is also called renal angiography.
Renal angiogram; Angiography - kidney
How the Test is Performed
This test is done in the hospital. You will lie on an x-ray table.
The health care provider will clean and shave an area of the body (most often near the groin). Numbing medicine will be applied to the area. A needle is then placed into the artery.
When the needle is in the proper position, a thin wire is passed through it into the artery. The needle is taken out, and a long, narrow, flexible tube called a catheter is put in its place.
The radiologist guides the catheter into the proper position with the help of x-ray images of the body. The images are made by an instrument called a fluoroscope and sent to a TV monitor that the doctor can see.
The catheter is pushed forward over the wire and into the aorta (the main blood vessel leading from the heart) and then into the kidney artery.
The test uses a special dye (called contrast) to help the arteries show up on the x-ray. The blood vessels of the kidneys cannot be seen with ordinary x-rays. The dye flows through the catheter into the kidney artery.
X-ray images are taken as the dye moves through the blood vessels. Saline (sterile salt water) containing a blood thinner may also be sent through the catheter to keep blood in the area from clotting.
The catheter is removed after the x-rays are taken. A closure device is placed in the groin or pressure is applied to the area to stop the bleeding. The area is checked after 10 or 15 minutes and a bandage is applied. You may be asked to keep your leg straight for 4 to 6 hours after the procedure.
How to Prepare for the Test
Tell the health care provider if:
- You are pregnant
- You have ever had any bleeding problems
- You currently take blood thinners, including daily aspirin
- You ever had any allergic reactions, especially those related to x-ray contrast material or iodine substances
- You have ever been diagnosed with kidney failure or poorly functioning kidneys
You must sign a consent form. Do not eat or drink anything for 6 - 8 hours before the test. You will be given a hospital gown to wear and asked to remove all jewelry. You may be given a sedative or pain pill before the procedure.
How the Test will Feel
You will lie flat on the x-ray table. There is usually a cushion but it is not as comfortable as a bed. You may feel a sting when the anesthesia medicine is given. You will not feel the dye. You may feel some pressure and discomfort as the catheter is positioned.
Some people feel a warm sensation when the dye is injected; however, most people cannot feel it. There may be slight tenderness and bruising at the site of the injection after the test.
Why the Test is Performed
The test is done to look at the blood vessels that feed the kidney. It may show:
- Aneurysm (a widening of the vein or artery)
- Abnormal connections between veins and arteries (fistulas)
- Blood clots
- Narrowing of the blood vessels of the kidneys (renal stenosis)
- Benign noncancerous tumors and malignant cancerous tumors
- Active bleeding from the kidney
Renal arteriography is often used to examine donors and recipients before a kidney transplant to determine the number of arteries and veins on each kidney. Many of the problems seen on the renal arteriogram, like aneurysm, and narrowing or bleeding of the kidney arteries can be treated when the arteriogram is done.
Results may vary. Talk to your doctor about the meaning of your specific test results.
What Abnormal Results Mean
Renal angiography may show the presence of tumors, narrowing of the artery or aneurysms (widening of the vein or artery), blood clots, fistulas, or bleeding in the kidney.
The test may also be done with the following conditions:
- Acute arterial occlusion of the kidney
- Atheroembolic renal disease
- Renal artery stenosis
- Renal cell carcinoma
- Angiomyolipomas (noncancerous tumors of the kidney)
The procedure is generally safe. The may be some risks, such as:
- Allergic reaction to the dye (contrast medium)
- Arterial occlusion from dissection
- Damage to the artery or artery wall, which can lead to blood clots
- Kidney damage from damage to the artery or from the dye
There is low radiation exposure. Pregnant women and children are more sensitive to the risks related to x-rays.
The test should NOT be done if you are pregnant or have bleeding problems.
Magnetic resonance angiography can be done on those who cannot have a renal arteriography exam. MRA is noninvasive and it can provide similar imaging of the kidney arteries, although it cannot be used for treatment.
Rottenberg G, Rankin S. Renal masses. In: Adam A, Dixon AK, eds. Grainger & Allison's Diagnostic Radiology: A Textbook of Medical Imaging. 5th ed. New York, NY: Churchill Livingstone; 2008:chap 40.
Weissleder R, Wittenberg J, et al. Vascular imaging. In: Weissleder R, Wittenberg J, et al. eds. Primer of Diagnostic Imaging. 5th ed. St. Louis, MO: Elsevier Mosby; 2011:chap 8.