Navigation Links
When Is Screening for Renal Artery Stenosis Medically Necessary?
Date:11/24/2008

PORTLAND, Ore., Nov. 24 /PRNewswire/ -- After diabetes and hypertension, renal artery stenosis is the leading cause of kidney failure. Recent changes in the opinions of nephrologists and cardiologists, as well as new medical guidelines, are increasing doctors' awareness of the need to screen for it.

"Our aging population, especially older patients with cerebrovascular, cardiac, and peripheral arterial disease increases the frequency of renal artery stenosis," said Dr. Skip Freedman, Executive Medical Director at AllMed Healthcare Management (http://www.allmedmd.com), a leading Independent Review Organization (IRO). "Many doctors are uncertain about the best way to screen for the disease or which patients to screen."

As a result, doctors either unnecessarily screen patients or order expensive and unneeded medical tests. This unneeded screening can result in an increased number of false-positive results. Following up on them often means invasive testing. These extra tests have both an inherent risk and increase the cost of treatment.

For a screening to be medically required, one of these conditions must exist:

    -- The patient is over 65-years old and diagnosed with high blood pressure
       (hypertension) for the first time.
    -- The patient has medically controlled blood pressure that is worsening.
    -- The patient has an acute kidney injury.
    -- The patient has a chronic kidney disease that's not explained by
       diabetes, volume depletion or some form of vascular disease.

This approach excludes routine screenings for renal artery stenosis in low risk hypertensive patients -- for example, a significantly obese young patient with no vascular disease, who also doesn't have other diseases, such as diabetes or sleep apnea would not need screening. The inability to control a patient's hypertension who is not on more than two blood pressure medications doesn't justify screening IF the patient doesn't meet one of the above four conditions. Doctors should avoid screening low risk patients because most times the positive results are "false positives" so additional testing only leads down blind alleys.

When one of the reasons to do renal artery stenosis screening is present, a renal artery doppler is the only initial medical screening needed. While it is less expensive than other tests, its drawbacks include its availability and the ultrasonographer's skill. Also screening larger patients is more difficult.

For an obese patient whose body-mass-index (BMI) exceeds 35, a doctor might consider imaging for other reasons. In this case, a CT angiogram or magnetic resonance angiography (MRA) of the renal arteries is needed only if the doppler test returned uncertain results or did not show the renal arteries clearly and is ordered by a cardiologist or nephrologist.

"Only when doctors find and document one of the four conditions in a patient is screening for renal artery stenosis medically necessary," Dr. Freedman said. "Following these guidelines will help decrease the unnecessary and inappropriate testing for renal artery stenosis, and improve the care of patients with the disease."

More information about the medical necessity review services offered by IROs can be found on AllMed's web site at http://www.allmedmd.com.


'/>"/>
SOURCE AllMed Healthcare Management
Copyright©2008 PR Newswire.
All rights reserved

Related medicine news :

1. Mexican Department of Public Health to Launch Screening for Papillomavirus, Cause of Cervical Cancer
2. Fear, misconceptions about screenings keep many African-Americans from getting mammograms
3. Messages of hope work better in motivating black patients to seek early screening for cancer
4. New technology could revolutionize breast cancer screening
5. Study Questions Screening Heart Attack Patients for Depression
6. Transitions Optical to Provide Free Vision Screenings at the American Diabetes Associations Feria de Salud por tu Familia(TM)
7. Columbus Medicare Diabetes Screening Project Cited as Model for State by Lt. Governor Casey Cagle
8. Minority patients discouraged from cancer screening by negative messages
9. Research indicates need for effective HPV vaccine for women and men and a simple HPV screening test
10. Free Flu Shots, Health, Dental Screenings and Services Available to New Kensington Area Adults
11. Parents comfortable with alcohol screening in pediatricians offices
Post Your Comments:
*Name:
*Comment:
*Email:
(Date:10/13/2017)... ... ... Journey: From the Mountains to the Mission Field”: the story of a missionary couple ... From the Mountains to the Mission Field” is the creation of published author, Carole ... and currently teaches a class of ladies at her church, which she has taught ...
(Date:10/12/2017)... , ... October 12, 2017 , ... Planet Fitness, one ... U.S., announced today its plans to open a flagship location in Covington, LA at ... former Rooms To Go store next to Office Depot in the Holiday Square shopping ...
(Date:10/12/2017)... ... October 12, 2017 , ... Asante, a ... health care, have expanded their existing home health joint venture through an agreement, ... been operating a joint venture home health company with Asante, delivering clinically integrated ...
(Date:10/12/2017)... ... October 12, 2017 , ... Leading pediatric oncology experts at ... for the 49th Congress of the International Society of Paediatric Oncology (SIOP) ... Center for Cancer and Blood Disorders at Children’s National, and Stephen P. ...
(Date:10/12/2017)... ... October 12, 2017 , ... In ... taxes a year. In some states—like New York, New Jersey, Massachusetts, Texas, Virginia, ... overseas retirement havens have extremely low property-tax rates, which contributes to the relatively ...
Breaking Medicine News(10 mins):
(Date:10/12/2017)... , Oct. 12, 2017 West Pharmaceutical ... innovative solutions for injectable drug administration, today announced that ... market opens on Thursday, October 26, 2017, and will ... and business expectations at 9:00 a.m. Eastern Time. To ... 253-336-8738 (International). The conference ID is 94093362. ...
(Date:10/11/2017)... IRVING, Texas , Oct. 11, 2017  Caris ... science focused on fulfilling the promise of precision medicine, ... Institute has joined Caris, Precision Oncology Alliance™ (POA) as ... leading cancer centers, the St. Jude Crosson Cancer Institute ... to advance the use of tumor profiling, making cancer ...
(Date:10/11/2017)... , Oct. 11, 2017  Hill-Rom Holdings, Inc. ("Hill-Rom") ... Surgical facility in Las Piedras, Puerto Rico ... and blades. ... the facility sustained minor structural damage, temporary loss of ... Repairs have been completed, manufacturing operations have resumed, and ...
Breaking Medicine Technology: