Renal Artery Atherosclerotic Disease G014

Current RMA Instruments
Reasonable Hypothesis SOP56 of 2020
Balance of Probabilities SOP57 of 2020
Changes from previous Instruments

ICD Coding
  • ICD-9-CM Codes: 440.1
  • ICD-10-AM Codes: I70.1
Brief description

This SOP applies to atherosclerosis of a renal artery that either requires treatment or results in clinical manifestations in the form of: acute pulmonary oedema; chronic heart failure; persistent renal impairment; or hypertension that is either moderate to severe, or poorly controlled (i.e. difficult to control).

Confirming the diagnosis

Renal artery atherosclerotic disease needs to be distinguished from other causes of chronic kindney disease and other causes of secondary hypertension. The diagnosis requires imaging showing significant stenosis (typically > 60%) of a renal artery.  CT angiography or MRI angiography are the preferred imaging methods.  Duplex doppler ultrasound can also be used but is inconclusive if the test is negative.  The condition is often unilateral.

The relevant medical specialist is a nephrologist.

Conditions not covered by SOP
  • Renal artery stenosis due to fibromuscular dysplasia*

* another SOP applies

Clinical onset

The condition is likely to present with a deterioration in renal function (often rapid), or with onset or worsening of hypertension (particularly rapid development of severe hypertension).  It may also cause acute pulmonary oedema (fluid in the lungs) or be found in connection with chronic heart failure.  The condition can also be found incidentally from radiological imaging (with contrast) performed for another reason.

Clinical worsening

Effective treatment options are available in the form of medical (drug) therapy and control of risk factors, stenting, and surgery.  The outcomes are variable, with improvement in some, stabilisation in others and progression to end stage renal disease in a further proportion.

 

Source URL: https://clik.dva.gov.au/ccps-medical-research-library/sops-grouped-icd-body-system/q-z/renal-artery-atherosclerotic-disease-g014-i701

Last amended

Rulebase for renal artery atherosclerotic disease

<h5>Current RMA Instruments</h5><table border="1" cellspacing="1" cellpadding="1"><tbody><tr><td><a href="http://www.rma.gov.au/assets/SOP/2020/7a7b06c9dd/056.pdf&quot; target="_blank">Reasonable Hypothesis SOP</a></td><td><span>56 of 2020</span></td></tr><tr><td><a href="http://www.rma.gov.au/assets/SOP/2020/052339caeb/057.pdf&quot; target="_blank">Balance of Probabilities SOP</a></td><td><span>57 of 2020</span></td></tr></tbody></table><h5>Changes from previous Instruments</h5><p><drupal-media data-entity-type="media" data-entity-uuid="c1861227-80fd-498f-944e-21ad70f160c4" data-view-mode="wysiwyg"></drupal-media></p><h5>ICD Coding</h5><ul><li>ICD-9-CM Codes: 440.1</li><li>ICD-10-AM Codes: I70.1</li></ul><h5>Brief description</h5><p>This SOP applies to atherosclerosis of a renal artery that either requires treatment or results in clinical manifestations in the form of: acute pulmonary oedema; chronic heart failure; persistent renal impairment; or hypertension that is either moderate to severe, or poorly controlled (i.e. difficult to control).</p><h5>Confirming the diagnosis</h5><p>Renal artery atherosclerotic disease needs to be distinguished from other causes of chronic kindney disease and other causes of secondary hypertension. The diagnosis requires imaging showing significant stenosis (typically &gt; 60%) of a renal artery.  CT angiography or MRI angiography are the preferred imaging methods.  Duplex doppler ultrasound can also be used but is inconclusive if the test is negative.  The condition is often unilateral.</p><p>The relevant medical specialist is a nephrologist.</p><h5>Conditions not covered by SOP</h5><ul><li>Renal artery stenosis due to fibromuscular dysplasia*</li></ul><p>* another SOP applies</p><h5>Clinical onset</h5><p>The condition is likely to present with a deterioration in renal function (often rapid), or with onset or worsening of hypertension (particularly rapid development of severe hypertension).  It may also cause acute pulmonary oedema (fluid in the lungs) or be found in connection with chronic heart failure.  The condition can also be found incidentally from radiological imaging (with contrast) performed for another reason.</p><h5>Clinical worsening</h5><p>Effective treatment options are available in the form of medical (drug) therapy and control of risk factors, stenting, and surgery.  The outcomes are variable, with improvement in some, stabilisation in others and progression to end stage renal disease in a further proportion.</p><p> </p>

Source URL: https://clik.dva.gov.au/ccps-medical-research-library/statements-principles/q-z/rulebase-renal-artery-atherosclerotic-disease

Cigar smoking

Current RMA Instruments
Reasonable Hypothesis SOP56 of 2020
Balance of Probabilities SOP57 of 2020
Changes from previous Instruments

ICD Coding
  • ICD-9-CM Codes: 440.1
  • ICD-10-AM Codes: I70.1
Brief description

This SOP applies to atherosclerosis of a renal artery that either requires treatment or results in clinical manifestations in the form of: acute pulmonary oedema; chronic heart failure; persistent renal impairment; or hypertension that is either moderate to severe, or poorly controlled (i.e. difficult to control).

Confirming the diagnosis

Renal artery atherosclerotic disease needs to be distinguished from other causes of chronic kindney disease and other causes of secondary hypertension. The diagnosis requires imaging showing significant stenosis (typically > 60%) of a renal artery.  CT angiography or MRI angiography are the preferred imaging methods.  Duplex doppler ultrasound can also be used but is inconclusive if the test is negative.  The condition is often unilateral.

The relevant medical specialist is a nephrologist.

Conditions not covered by SOP
  • Renal artery stenosis due to fibromuscular dysplasia*

* another SOP applies

Clinical onset

The condition is likely to present with a deterioration in renal function (often rapid), or with onset or worsening of hypertension (particularly rapid development of severe hypertension).  It may also cause acute pulmonary oedema (fluid in the lungs) or be found in connection with chronic heart failure.  The condition can also be found incidentally from radiological imaging (with contrast) performed for another reason.

Clinical worsening

Effective treatment options are available in the form of medical (drug) therapy and control of risk factors, stenting, and surgery.  The outcomes are variable, with improvement in some, stabilisation in others and progression to end stage renal disease in a further proportion.

 

Source URL: https://clik.dva.gov.au/ccps-medical-research-library/statements-principles/q-z/renal-artery-atherosclerotic-disease-g014-i701/rulebase-renal-artery-atherosclerotic-disease/cigar-smoking

Cigarette smoking

Current RMA Instruments
Reasonable Hypothesis SOP56 of 2020
Balance of Probabilities SOP57 of 2020
Changes from previous Instruments

ICD Coding
  • ICD-9-CM Codes: 440.1
  • ICD-10-AM Codes: I70.1
Brief description

This SOP applies to atherosclerosis of a renal artery that either requires treatment or results in clinical manifestations in the form of: acute pulmonary oedema; chronic heart failure; persistent renal impairment; or hypertension that is either moderate to severe, or poorly controlled (i.e. difficult to control).

Confirming the diagnosis

Renal artery atherosclerotic disease needs to be distinguished from other causes of chronic kindney disease and other causes of secondary hypertension. The diagnosis requires imaging showing significant stenosis (typically > 60%) of a renal artery.  CT angiography or MRI angiography are the preferred imaging methods.  Duplex doppler ultrasound can also be used but is inconclusive if the test is negative.  The condition is often unilateral.

The relevant medical specialist is a nephrologist.

Conditions not covered by SOP
  • Renal artery stenosis due to fibromuscular dysplasia*

* another SOP applies

Clinical onset

The condition is likely to present with a deterioration in renal function (often rapid), or with onset or worsening of hypertension (particularly rapid development of severe hypertension).  It may also cause acute pulmonary oedema (fluid in the lungs) or be found in connection with chronic heart failure.  The condition can also be found incidentally from radiological imaging (with contrast) performed for another reason.

Clinical worsening

Effective treatment options are available in the form of medical (drug) therapy and control of risk factors, stenting, and surgery.  The outcomes are variable, with improvement in some, stabilisation in others and progression to end stage renal disease in a further proportion.

 

Source URL: https://clik.dva.gov.au/ccps-medical-research-library/statements-principles/q-z/renal-artery-atherosclerotic-disease-g014-i701/rulebase-renal-artery-atherosclerotic-disease/cigarette-smoking

Diabetes mellitus

Current RMA Instruments
Reasonable Hypothesis SOP56 of 2020
Balance of Probabilities SOP57 of 2020
Changes from previous Instruments

ICD Coding
  • ICD-9-CM Codes: 440.1
  • ICD-10-AM Codes: I70.1
Brief description

This SOP applies to atherosclerosis of a renal artery that either requires treatment or results in clinical manifestations in the form of: acute pulmonary oedema; chronic heart failure; persistent renal impairment; or hypertension that is either moderate to severe, or poorly controlled (i.e. difficult to control).

Confirming the diagnosis

Renal artery atherosclerotic disease needs to be distinguished from other causes of chronic kindney disease and other causes of secondary hypertension. The diagnosis requires imaging showing significant stenosis (typically > 60%) of a renal artery.  CT angiography or MRI angiography are the preferred imaging methods.  Duplex doppler ultrasound can also be used but is inconclusive if the test is negative.  The condition is often unilateral.

The relevant medical specialist is a nephrologist.

Conditions not covered by SOP
  • Renal artery stenosis due to fibromuscular dysplasia*

* another SOP applies

Clinical onset

The condition is likely to present with a deterioration in renal function (often rapid), or with onset or worsening of hypertension (particularly rapid development of severe hypertension).  It may also cause acute pulmonary oedema (fluid in the lungs) or be found in connection with chronic heart failure.  The condition can also be found incidentally from radiological imaging (with contrast) performed for another reason.

Clinical worsening

Effective treatment options are available in the form of medical (drug) therapy and control of risk factors, stenting, and surgery.  The outcomes are variable, with improvement in some, stabilisation in others and progression to end stage renal disease in a further proportion.

 

Source URL: https://clik.dva.gov.au/ccps-medical-research-library/statements-principles/q-z/renal-artery-atherosclerotic-disease-g014-i701/rulebase-renal-artery-atherosclerotic-disease/diabetes-mellitus

Dyslipidaemia

Current RMA Instruments
Reasonable Hypothesis SOP56 of 2020
Balance of Probabilities SOP57 of 2020
Changes from previous Instruments

ICD Coding
  • ICD-9-CM Codes: 440.1
  • ICD-10-AM Codes: I70.1
Brief description

This SOP applies to atherosclerosis of a renal artery that either requires treatment or results in clinical manifestations in the form of: acute pulmonary oedema; chronic heart failure; persistent renal impairment; or hypertension that is either moderate to severe, or poorly controlled (i.e. difficult to control).

Confirming the diagnosis

Renal artery atherosclerotic disease needs to be distinguished from other causes of chronic kindney disease and other causes of secondary hypertension. The diagnosis requires imaging showing significant stenosis (typically > 60%) of a renal artery.  CT angiography or MRI angiography are the preferred imaging methods.  Duplex doppler ultrasound can also be used but is inconclusive if the test is negative.  The condition is often unilateral.

The relevant medical specialist is a nephrologist.

Conditions not covered by SOP
  • Renal artery stenosis due to fibromuscular dysplasia*

* another SOP applies

Clinical onset

The condition is likely to present with a deterioration in renal function (often rapid), or with onset or worsening of hypertension (particularly rapid development of severe hypertension).  It may also cause acute pulmonary oedema (fluid in the lungs) or be found in connection with chronic heart failure.  The condition can also be found incidentally from radiological imaging (with contrast) performed for another reason.

Clinical worsening

Effective treatment options are available in the form of medical (drug) therapy and control of risk factors, stenting, and surgery.  The outcomes are variable, with improvement in some, stabilisation in others and progression to end stage renal disease in a further proportion.

 

Source URL: https://clik.dva.gov.au/ccps-medical-research-library/statements-principles/q-z/renal-artery-atherosclerotic-disease-g014-i701/rulebase-renal-artery-atherosclerotic-disease/dyslipidaemia

Hypertension

Current RMA Instruments
Reasonable Hypothesis SOP56 of 2020
Balance of Probabilities SOP57 of 2020
Changes from previous Instruments

ICD Coding
  • ICD-9-CM Codes: 440.1
  • ICD-10-AM Codes: I70.1
Brief description

This SOP applies to atherosclerosis of a renal artery that either requires treatment or results in clinical manifestations in the form of: acute pulmonary oedema; chronic heart failure; persistent renal impairment; or hypertension that is either moderate to severe, or poorly controlled (i.e. difficult to control).

Confirming the diagnosis

Renal artery atherosclerotic disease needs to be distinguished from other causes of chronic kindney disease and other causes of secondary hypertension. The diagnosis requires imaging showing significant stenosis (typically > 60%) of a renal artery.  CT angiography or MRI angiography are the preferred imaging methods.  Duplex doppler ultrasound can also be used but is inconclusive if the test is negative.  The condition is often unilateral.

The relevant medical specialist is a nephrologist.

Conditions not covered by SOP
  • Renal artery stenosis due to fibromuscular dysplasia*

* another SOP applies

Clinical onset

The condition is likely to present with a deterioration in renal function (often rapid), or with onset or worsening of hypertension (particularly rapid development of severe hypertension).  It may also cause acute pulmonary oedema (fluid in the lungs) or be found in connection with chronic heart failure.  The condition can also be found incidentally from radiological imaging (with contrast) performed for another reason.

Clinical worsening

Effective treatment options are available in the form of medical (drug) therapy and control of risk factors, stenting, and surgery.  The outcomes are variable, with improvement in some, stabilisation in others and progression to end stage renal disease in a further proportion.

 

Source URL: https://clik.dva.gov.au/ccps-medical-research-library/statements-principles/q-z/renal-artery-atherosclerotic-disease-g014-i701/rulebase-renal-artery-atherosclerotic-disease/hypertension

No appropriate clinical management for renal artery atherosclerotic disease

Current RMA Instruments
Reasonable Hypothesis SOP56 of 2020
Balance of Probabilities SOP57 of 2020
Changes from previous Instruments

ICD Coding
  • ICD-9-CM Codes: 440.1
  • ICD-10-AM Codes: I70.1
Brief description

This SOP applies to atherosclerosis of a renal artery that either requires treatment or results in clinical manifestations in the form of: acute pulmonary oedema; chronic heart failure; persistent renal impairment; or hypertension that is either moderate to severe, or poorly controlled (i.e. difficult to control).

Confirming the diagnosis

Renal artery atherosclerotic disease needs to be distinguished from other causes of chronic kindney disease and other causes of secondary hypertension. The diagnosis requires imaging showing significant stenosis (typically > 60%) of a renal artery.  CT angiography or MRI angiography are the preferred imaging methods.  Duplex doppler ultrasound can also be used but is inconclusive if the test is negative.  The condition is often unilateral.

The relevant medical specialist is a nephrologist.

Conditions not covered by SOP
  • Renal artery stenosis due to fibromuscular dysplasia*

* another SOP applies

Clinical onset

The condition is likely to present with a deterioration in renal function (often rapid), or with onset or worsening of hypertension (particularly rapid development of severe hypertension).  It may also cause acute pulmonary oedema (fluid in the lungs) or be found in connection with chronic heart failure.  The condition can also be found incidentally from radiological imaging (with contrast) performed for another reason.

Clinical worsening

Effective treatment options are available in the form of medical (drug) therapy and control of risk factors, stenting, and surgery.  The outcomes are variable, with improvement in some, stabilisation in others and progression to end stage renal disease in a further proportion.

 

Source URL: https://clik.dva.gov.au/ccps-medical-research-library/statements-principles/q-z/renal-artery-atherosclerotic-disease-g014-i701/rulebase-renal-artery-atherosclerotic-disease/no-appropriate-clinical-management-renal-artery-atherosclerotic-disease

Pipe smoking

Current RMA Instruments
Reasonable Hypothesis SOP56 of 2020
Balance of Probabilities SOP57 of 2020
Changes from previous Instruments

ICD Coding
  • ICD-9-CM Codes: 440.1
  • ICD-10-AM Codes: I70.1
Brief description

This SOP applies to atherosclerosis of a renal artery that either requires treatment or results in clinical manifestations in the form of: acute pulmonary oedema; chronic heart failure; persistent renal impairment; or hypertension that is either moderate to severe, or poorly controlled (i.e. difficult to control).

Confirming the diagnosis

Renal artery atherosclerotic disease needs to be distinguished from other causes of chronic kindney disease and other causes of secondary hypertension. The diagnosis requires imaging showing significant stenosis (typically > 60%) of a renal artery.  CT angiography or MRI angiography are the preferred imaging methods.  Duplex doppler ultrasound can also be used but is inconclusive if the test is negative.  The condition is often unilateral.

The relevant medical specialist is a nephrologist.

Conditions not covered by SOP
  • Renal artery stenosis due to fibromuscular dysplasia*

* another SOP applies

Clinical onset

The condition is likely to present with a deterioration in renal function (often rapid), or with onset or worsening of hypertension (particularly rapid development of severe hypertension).  It may also cause acute pulmonary oedema (fluid in the lungs) or be found in connection with chronic heart failure.  The condition can also be found incidentally from radiological imaging (with contrast) performed for another reason.

Clinical worsening

Effective treatment options are available in the form of medical (drug) therapy and control of risk factors, stenting, and surgery.  The outcomes are variable, with improvement in some, stabilisation in others and progression to end stage renal disease in a further proportion.

 

Source URL: https://clik.dva.gov.au/ccps-medical-research-library/statements-principles/q-z/renal-artery-atherosclerotic-disease-g014-i701/rulebase-renal-artery-atherosclerotic-disease/pipe-smoking

Smoking tobacco products - material contribution

Current RMA Instruments
Reasonable Hypothesis SOP56 of 2020
Balance of Probabilities SOP57 of 2020
Changes from previous Instruments

ICD Coding
  • ICD-9-CM Codes: 440.1
  • ICD-10-AM Codes: I70.1
Brief description

This SOP applies to atherosclerosis of a renal artery that either requires treatment or results in clinical manifestations in the form of: acute pulmonary oedema; chronic heart failure; persistent renal impairment; or hypertension that is either moderate to severe, or poorly controlled (i.e. difficult to control).

Confirming the diagnosis

Renal artery atherosclerotic disease needs to be distinguished from other causes of chronic kindney disease and other causes of secondary hypertension. The diagnosis requires imaging showing significant stenosis (typically > 60%) of a renal artery.  CT angiography or MRI angiography are the preferred imaging methods.  Duplex doppler ultrasound can also be used but is inconclusive if the test is negative.  The condition is often unilateral.

The relevant medical specialist is a nephrologist.

Conditions not covered by SOP
  • Renal artery stenosis due to fibromuscular dysplasia*

* another SOP applies

Clinical onset

The condition is likely to present with a deterioration in renal function (often rapid), or with onset or worsening of hypertension (particularly rapid development of severe hypertension).  It may also cause acute pulmonary oedema (fluid in the lungs) or be found in connection with chronic heart failure.  The condition can also be found incidentally from radiological imaging (with contrast) performed for another reason.

Clinical worsening

Effective treatment options are available in the form of medical (drug) therapy and control of risk factors, stenting, and surgery.  The outcomes are variable, with improvement in some, stabilisation in others and progression to end stage renal disease in a further proportion.

 

Source URL: https://clik.dva.gov.au/ccps-medical-research-library/statements-principles/q-z/renal-artery-atherosclerotic-disease-g014-i701/rulebase-renal-artery-atherosclerotic-disease/smoking-tobacco-products-material-contribution

Treatment with oral angiotensin converting enzyme (ACE) inhibitors

Current RMA Instruments
Reasonable Hypothesis SOP56 of 2020
Balance of Probabilities SOP57 of 2020
Changes from previous Instruments

ICD Coding
  • ICD-9-CM Codes: 440.1
  • ICD-10-AM Codes: I70.1
Brief description

This SOP applies to atherosclerosis of a renal artery that either requires treatment or results in clinical manifestations in the form of: acute pulmonary oedema; chronic heart failure; persistent renal impairment; or hypertension that is either moderate to severe, or poorly controlled (i.e. difficult to control).

Confirming the diagnosis

Renal artery atherosclerotic disease needs to be distinguished from other causes of chronic kindney disease and other causes of secondary hypertension. The diagnosis requires imaging showing significant stenosis (typically > 60%) of a renal artery.  CT angiography or MRI angiography are the preferred imaging methods.  Duplex doppler ultrasound can also be used but is inconclusive if the test is negative.  The condition is often unilateral.

The relevant medical specialist is a nephrologist.

Conditions not covered by SOP
  • Renal artery stenosis due to fibromuscular dysplasia*

* another SOP applies

Clinical onset

The condition is likely to present with a deterioration in renal function (often rapid), or with onset or worsening of hypertension (particularly rapid development of severe hypertension).  It may also cause acute pulmonary oedema (fluid in the lungs) or be found in connection with chronic heart failure.  The condition can also be found incidentally from radiological imaging (with contrast) performed for another reason.

Clinical worsening

Effective treatment options are available in the form of medical (drug) therapy and control of risk factors, stenting, and surgery.  The outcomes are variable, with improvement in some, stabilisation in others and progression to end stage renal disease in a further proportion.

 

Source URL: https://clik.dva.gov.au/ccps-medical-research-library/statements-principles/q-z/renal-artery-atherosclerotic-disease-g014-i701/rulebase-renal-artery-atherosclerotic-disease/treatment-oral-angiotensin-converting-enzyme-ace-inhibitors