- Peak Systolic Velocity in the Aorta -taken above the level of the renal arteries origin.Taken with and without an angle for a ratio with the renal artery.
- Renal Artery Assessment- initially with colour Doppler.
- Renal Artery Spectral Analysis- Origin,Proximal,Mid and Distal Artery .If a stenosis is suspected then a velocity with an angle to compare with the aorta to give a ratio (>3.5:1 is a >60% stenosis which is haemodynamically significant). If an accurate angle cannot be obtained in the renal artery then a ratio is done with no angle on either the renal artery or the aorta.
- Interlobar/Segmental Artery Spectral Analysis- Acceleration Time (AT) and Resistive index (RI).(AT <70msec and RI >0.8 for chronic renal disease)
INDIRECT METHOD
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- Aorta B Mode -Longitudinal and Transverse to assess for an abdominal aortic aneurysm.
- Kidney lengths-cortex assessment for reduced size.
- Perfusion Kidney- colour Doppler used to assess the perfusion to the edge of the renal cortex.
- Resistive Index- Spectral Doppler of kidney parenchyma at the interlobar (segmental) arteries and interlobular (arcuate)arteries.
- Acceleration Time