When to Have a Renal Arteriography

If other tests are inconclusive, this procedure can give a clearer picture

A renal arteriography, also known as a renal angiogram, is a special X-ray procedure that shows the blood vessels in the kidney. It allows healthcare providers to observe the blood flow through the kidney.

The test is used as a follow-up to other, less-invasive tests and can help diagnose conditions such as aneurysms, fistulas, blood clots in the kidneys, and unexplained high blood pressure. It’s also used to examine the kidneys of donors and recipients before and after kidney transplants.

Continue reading to learn more about renal arteriography, including why you might need one, what to expect, how to prepare, and what recovery will be like. 

Doctor reviewing X-rays

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Goal of Renal Arteriography 

A renal arteriography allows healthcare providers to see a picture of the blood vessels in your kidneys. Normally, blood vessels don’t show up on X-rays. A renal angiogram uses a catheter to send dye into the blood vessels, so they appear when an X-ray is taken. 

This helps healthcare providers understand whether there are any issues with the blood flow through your kidney, which could indicate kidney disease. If you have unexplained high blood pressure that might be linked to your kidneys, they may order this procedure.

It’s also used for patients who have a kidney artery that is inflamed or closed. Sometimes, it can be used to measure blood flow to the kidney before or after a kidney transplant.

Who Performs the Test?

A renal arteriography is performed by a radiologist, a doctor trained in using images to diagnose a condition. In this case, the radiologist is using X-rays taken during the renal arteriography to identify and diagnose problems with the blood flow to your kidney. The radiologist is often assisted by nurses. 

Getting a Referral 

You won’t be referred for a renal arteriography until you’ve already had some diagnostic procedures done. These might include ultrasound, CT (computed tomography) scan, or magnetic resonance imaging (MRI).

Before You Go 

Before getting a renal angiogram, you should speak with your healthcare provider about any concerns that you have. They will tell you what to expect from the procedure and explain why they think the procedure is necessary. They should also discuss any potential side effects, and help you weigh the pros and cons of having this procedure. Generally, a renal arteriography is very safe.

You should not eat or drink after midnight before having the procedure. If you’re on regular medication or take any supplements, talk to your healthcare provider about whether you should refrain from taking these on the day of the procedure.

Possible Risks 

Although a renal arteriography is safe, it carries some possible risks, just like any other medical procedure. These can include:

  • Allergic reaction to the dye
  • Damage to the arteries
  • Blood clots
  • Kidney damage

Since there is a low level of radiation associated with this procedure, you should tell your healthcare provider if you are pregnant or breastfeeding. 

Renal Arteriography Test Walk-Through

A renal arteriography is an outpatient procedure, but you’ll be at the hospital for about eight hours. When you arrive you’ll sign consent forms and put on a hospital gown, just like you’re preparing for surgery. 

You’ll be awake for the procedure but you’ll be given a sedative so that you’re able to relax. Before the surgery, you’ll likely have an intravenous catheter (IV) placed in your hand or arm so nurses can administer fluids and any necessary medication. 

Once it’s time for the procedure, here’s what you can expect:

  • A nurse will clean and shave a spot on your groin where the catheter will be placed in your artery. 
  • A nurse will apply numbing cream.
  • A needle will be placed in your artery. 
  • A doctor will place a catheter—a long, flexible tube—into your artery. 
  • A doctor will guide the catheter using images projected on a screen. It will pass into your artery in the groin, through the heart, and into the kidney artery. 
  • Once the doctor places the catheter in the correct spot they will inject the dye, which passes into the blood vessels of your kidneys. 
  • After that, the doctor will take X-ray images from a variety of angles. You’ll lie still, while the X-ray machines move around you. You will need to follow instructions, like holding your breath for 10 seconds while the pictures are being taken.

When the doctor has all the pictures they need, you’ll be taken to a recovery area where a doctor or nurse will remove the catheter and apply pressure to your groin for up to 20 minutes to prevent bleeding. After that, you’ll need to lie flat without moving your leg for about four hours. Then, you’re ready to be driven home. 

Reminders After the Test 

It’s important to follow your care instructions right after the procedure to ensure that you don’t bleed from the site where the catheter was placed. If you need help with eating, drinking, urinating or anything else, ask your nurse for assistance. 

After the renal arteriography, give yourself time to recover. You shouldn’t drive for 24 hours, or exercise vigorously for about a week.

What Your Results Mean 

A renal arteriogram provides a unique picture of the blood flow through your kidney. It can detect conditions like inflamed arteries, tumors, blood clots, or bleeds. But you won’t have easy-to-read numerical results. Instead, your healthcare provider will talk to you about what they found during your procedure, and what that might mean to your health. 

Summary

A renal arteriography is an outpatient procedure that allows doctors to take X-ray images of the blood flow in your kidney. To do this, doctors insert a catheter, most often in your groin, and guide it into the kidney arteries. Once it's placed, the doctor inserts dye, which allows the blood vessels to appear on X-ray images. They will take various images and will discuss what they find with you during a follow-up appointment. 

A Word From Verywell 

Needing a renal arteriography can be scary, especially when it comes after other medical testing. Healthcare providers will do their best to make you physically and emotionally comfortable during the procedure. If you’re worried, remind yourself that a renal arteriogram can help you get the answers you’ve been seeking about your health. 

Frequently Asked Questions

  • Does a renal angiogram hurt?

    A renal angiogram can be uncomfortable, but providers do their best to make sure you are not in pain. You’ll be given a sedative to help you relax, and a local anesthetic at the place where the catheter is inserted, which often is your groin. You don’t feel the catheter once it’s placed, but you might experience a burning sensation in your legs when the dye is inserted. This goes away within 30 seconds.

  • Is a renal arteriography the same as an angiography?

    Yes, a renal arteriography is the same as renal angiography.

  • When would someone need to have a renal arteriography?

    Renal arteriography is ordered when healthcare providers need more information about blood flow to and within your kidney. This procedure is often done after other imaging procedures like CT scans or MRIs. It can detect changes to your arteries, blood clots, and other obstructions to the path of blood through the kidneys. 

2 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. MedlinePlus. Renal arteriography.

  2. Johns Hopkins Medicine. Renal arteriogram.

By Kelly Burch
Kelly Burch is has written about health topics for more than a decade. Her writing has appeared in The Washington Post, The Chicago Tribune, and more.