secretion of adrenocorticotropic hormone from the anterior pituitary.

secretion of aldosterone from the adrenal cortex.

secretion of angiotensinogen by the liver.

conversion of angiotensinogen to angiotensin I.

conversion of angiotensin I to angiotensin II.

the adrenal gland.

the liver.

the lung.

the brain.

the kidney.

β-adrenergic stimulation of the kidney.

diminished chloride delivery to the distal tubule.

diminished potassium delivery to the distal tubule.

exogenous prostaglandins.

diminished stretch of the afferent arteriole.

is the major enzyme for degradation of angiotensin II.

forms angiotensin I from angiotensinogen.

is the only enzyme in the formation of angiotensin II that cannot be pharmacologically modulate

is a specific enzyme that converts angiotensin I to angiotensin II.

is a nonspecific enzyme that has several functions in vivo.

vasoconstriction.

secretion of epinephrine.

secretion of aldosterone.

cardiac muscle hypertrophy.

thirst.

efferent arteriolar vasoconstriction.

afferent arteriolar vasoconstriction.

afferent arteriolar vasodilatation.

efferent arteriolar vasodilatation.

main renal artery vasoconstriction.

a close resemblance to human clinical renovascular hypertension.

constant sensitivity to ACE inhibition.

dynamic change through different pathophysiologic phases.

the late renin-dependent phase of hypertension.

the early volume-dependent phase of hypertension.

is a benign phenomenon, usually limited to the lower extremities, that rarely involves the kidney.

is usually managed by percutaneous transluminal angioplasty.

frequently contributes to deterioration of renal function in patients with atherosclerotic renal artery stenosis.

occurs mainly in young patients with fibrous renal artery disease.

is usually managed by exploration and immediate surgical repair.

is only significant if associated with other vascular (e.g., aortic) disease.

indicates that surgical or endovascular repair is necessary.

is only significant if stenosis is more than 70%.

is exclusively the result of renal artery atherosclerosis.

should be excluded in every patient with high blood pressure.

is generally not pursued in azotemic patients.

can be confirmed by clinical examination alone.

is usually confirmed through laboratory testing.

is based on wide radiologic screening of asymptomatic patients.

is based on radiologic confirmation of clinically suspicious cases.

intra-arterial angiography.

rapid sequence intravenous urography.

intraoperative digital subtraction angiography.

duplex ultrasonography.

magnetic resonance angiography.

has the advantage of mobility, widespread availability, noninvasiveness, and no effect on renal function.

has the advantage of providing excellent anatomic detail.

can provide all the necessary information for treatment of patients with ischemic nephropathy.

is limited by the need to transport patients to an imaging facility.

is not useful as a screening test for patients where renal artery stenosis is suspected.

is associated with a higher incidence of arterial wall trauma than is standard angiography.

is associated with a high incidence of allergic complications and gas embolism.

is a noninvasive diagnostic technique that minimizes the risk associated with iodinated contrast angiography.

is an invasive diagnostic modality that is especially useful in patients with renal insufficiency.

cannot be used if angioplasty is contemplate.

is the best chance for maintaining renal function.

is appropriate therapy for young patients with ischemic nephropathy.

rarely succeeds in controlling hypertension.

is generally preferred for children.

is appropriate therapy for older patients with mild hypertension.

is usually indicated in cases of ischemic nephropathy rather than renovascular hypertension.

is indicated for bilateral renal artery stenosis, provided that total renal function is normal.

rarely provides long-term therapeutic benefit even in properly selected cases.

is indicated for hypertension caused by a unilateral, small, poorly functioning kidney.

should be performed exclusively using open surgical technique and not laparoscopically.