ABSTRACT
Introduction Diabetes mellitus is a state of accelerated and often widespread macrovascular disease. Atherosclerotic renovascular disease is more common in patients with clinical evidence of vascular disease, particularly peripheral vascular disease. Consequently there is a need to consider the possibility of renal artery stenosis (RAS) in a diabetic patient with hypertension. This diagnosis has particular significance in the hypertensive diabetic patient for a number of reasons: 1) Diabetic patients are frequently treated with ACE-inhibition or angiotensin receptor antagonists which can precipitate a decline in renal function in patients with RAS. 2) RAS is a potentially remediable cause of hypertension and/or heart failure. This is an important consideration mindful of the devastating effects of uncontrolled hypertension in people with diabetes and the common occurrence of heart failure. 3) RAS can contribute to a progressive decline in renal function which can be erroneously attributed to diabetic nephropathy if the RAS remains undetected.
