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:7/25/2017)... ... July 25, 2017 , ... ... announced it will be exhibiting and providing demos of its smart journaling platform ... Washington Convention Center in Washington D.C. from August 3-6, 2017. , The APA ...
(Date:7/25/2017)... Jacksonville, Fla. (PRWEB) , ... July 25, 2017 , ... ... employee and father Ezra Clark is taking advantage of a new benefit for employees ... “It really means a lot that the company supports me and other employees as ...
(Date:7/24/2017)... Florida (PRWEB) , ... July ... ... Division Marketing Director,      (407) 916-7235, kklaproth(at)robinsmorton(dot)com , Robins & ... joined together to celebrate the structural topping out of the new Destination ...
(Date:7/24/2017)... , ... July 24, 2017 , ... ... federal Substance Abuse and Mental Health Services Administration’s (SAMHSA) State Targeted Response to ... Department of Health Care Services, will facilitate the development of a hub and ...
(Date:7/24/2017)... ... ... The International Essential Tremor Foundation (IETF) will host a free educational forum in ... take place on Saturday, Aug. 26 at the Embassy Suites by Hilton Cleveland Rockside ... a.m. to 12 p.m., with check-in beginning at 8 a.m. The event is sponsored ...
Breaking Medicine News(10 mins):
(Date:7/11/2017)... Md. , July 11, 2017  The global ... estimated revenues of approximately $394.1 million in 2016.  Although ... trend of solid growth, in particular as a result ... clinical practice, and the recent introduction of a significant ... need for less-invasive testing of tumor biomarkers to guide ...
(Date:7/11/2017)... 11, 2017 Oramed Pharmaceuticals Inc. (NASDAQ: ... company focused on the development of oral drug delivery ... Administration (FDA) has agreed to schedule an End-of-Phase II ... trial of its oral insulin capsule ORMD-0801 in the ... met primary and secondary endpoints by indicating a statistically ...
(Date:7/10/2017)... , July 10, 2017  BDI Group ... and patient support services organization serving specialty pharmacies, ... the launch of four significant, value-added member programs ... insights, better manage reimbursement and improve access and ... factor therapies. ...
Breaking Medicine Technology: