What to Know About Renal Arteriography

Medically Reviewed by Carol DerSarkissian, MD on February 21, 2024
3 min read

Renal arteriography is an imaging test or X-ray used to see the blood vessels in your kidneys. The test can help your doctor identify different health conditions. These include aneurysms (ballooning of a blood vessel), stenosis (narrowing of the vessel), or blockages. 

A renal angiogram is another name for renal arteriography or renal arteriogram.

In a renal arteriogram, fluoroscopy is used, which is a type of X-ray that takes continuous pictures. It can show the blood flow to the kidneys, along with your internal organs and bones.

The renal angiogram procedure starts with the insertion of a catheter — a thin, flexible tube. The radiologist puts the catheter into a blood vessel leading to your kidney through a small incision (cut) usually in the groin. The X-ray dye is injected through the catheter into the artery and X-rays are taken.

This makes the blood vessels more visible in the X-ray images.

A specialist called an interventional radiologist usually performs the renal angiogram.

Why Do I Need a Renal Angiogram?

A renal angiogram helps your doctor identify problems in your kidneys. Problems could include:

  • Aneurysm, a bulge in the blood vessel
  • Renal artery stenosis, narrowing of arteries that supply blood to the kidneys
  • Vasospasm, sudden contraction of the blood vessels
  • Arteriovenous malformation, an abnormal formation of blood vessels
  • Thrombosis, a blockage of blood vessels due to blood clots
  • Occlusion, the blockage of a blood vessel

Your doctor may also recommend a renal angiogram to diagnose:

  • Any kind of tumor
  • Hemorrhage, bleeding of the blood vessels 
  • Kidney transplant complications

You may also need a renal angiogram if a computed tomography (CT) scan or magnetic resonance imaging (MRI) didn't show your blood vessels clearly.

Here is what to expect when you go for a renal angiogram:

Before the procedure:

  • Follow all the instructions your doctor gives you to prepare for the angiogram. 
  • Tell your doctor if you are pregnant, may be pregnant, are breastfeeding, or are allergic to X-ray dyes or any medicine. 
  • Tell your doctor about any medical condition you have.
  • Your doctor may ask you to stop taking some medicines. This includes all prescription drugs, supplements, and over-the-counter drugs (ibuprofen or aspirin). 

During the procedure:

  • You will be asked to wear a hospital gown and lie straight on an X-ray table. The doctor will give you necessary fluids and medicines through an IV line. This will help you relax before the procedure starts.
  • The doctor will numb the insertion area on your body, often in the groin. They will insert a needle through your skin into the blood vessel. After that, a catheter will be inserted into the blood vessel.  
  • An X-ray dye will be injected into your blood vessels to make them more prominent. The radiologist will use these X-ray images to insert the catheter to the narrowed kidney (renal) artery through the blood vessels.
  • Once the catheter is in position, the narrowing of the renal artery is gradually widened. This procedure is known as renal artery angioplasty.
  • The doctor will ask you not to move during the procedure. You will have to stay still with the help of pillows and foam pads. The doctor may even ask you to hold your breath for 10-25 seconds frequently.
  • As the procedure completes, the doctor takes out the catheter. To stop the bleeding of the insertion area, the doctor will put pressure on it for 15 minutes. 

After the procedure

  • If the bleeding doesn't stop, the doctor will ask you to lie straight and not move the leg of the insertion area for six hours.
  • It's better to stay in the hospital that night to avoid any mishap at home.
  • The doctor will advise you to drink plenty of water to remove the X-ray dye from your body.
  • You have to take care of the insertion site after reaching home.

A renal angiogram has some risks, including:

  • Bleeding
  • Nerve injuries
  • Temporary kidney failure
  • Blood clots 
  • Hematoma, swelling due to blood collection
  • Any infection
  • Damage to an artery or its wall

Some risks and complications can also arise due to any health condition you already have. Always inform the medical staff about your medical history before the procedure.