If a sensitive test comes back negative we can reliably exclude the disease. If a specific test comes back positive we can be confident that we have a diagnosis.
My daughter was diagnosed with this when she was 5, after she was found to have a high bp. The high bp was found during routine observations for something else. She had an angioplasty a couple of months later, and her blood pressure has mostly stayed at normal levels. The stenosis was due to Neurofibromatosis type 1
Hello, I’m surprised that someone as young as 5 has this already. I’m so sorry. I was diagnosed 7 months ago because I went to the hospital with a nose bleed that wouldn’t stop and my blood pressure was 165/144. I now am on bp meds twice a day and have my blood taken every other month and see a nephrologist every 6 months. Do you think your daughter will have the surgery to open up the artery?
@@lajewel4615 She had surgery a couple of months after diagnosis to open up the artery via an angioplasty procedure. She has just turned 6 at the time. She is now 10. Her blood pressure is mostly stable but she can have peroids where it goes high, and she gets monitored, but overall she is doing well. She also sees nephrology every 6 months.
I don't understand what you mean but specific test exclude other causes whereas sensitive test is positive in the disease as well as many other diseases For example ESR is sensitive in rheumatic fever but not specific as it is positive also in many other diseases
They have reduced renal perfusion due to atherosclerotic blockage. In patients with bilateral renal artery stenosis, the reduced systemic pressure (when given ACEI) is no longer able to overcome the stenosis and renal blood flow drops. ACEI also relatively dilate the efferent arteriole. These patients are dependent on angiotensin II efferent arteriole vasoconstriction in order to maintain GFR. Although patients with bilateral RAS are at risk for acute kidney failure, most patients can tolerate the medication with only a minor rise in serum creatinine (
@@cardamomes in such case, ACE & RENIN is still inhibited. That will lead to diabetic insipidus in which ANP & BNP will regulate afferent dilation with efferent constriction. With lots of NA++ secretion , Adenosine & Adrenaline will maintain GFR raising SVR till prostaglandin kicks in dilating both afferent & efferent . Then Dopamine kicks in to decrease SVR back in & regulating glucocoticoid to decrease inflammation back to normal lumen !
Water pipe when constricted increases flow of water(Formula:A1V1=A2V2). But blood vessels when constricted decreases flow of blood. Because density increases more than decrease in Area (here formula changes to D1A1V1=D2A2V2. D=density,A=Area,V=Velocity.) Am I correct??
If blockage is less than 50% at ostium of right renal artery only. Stent can't be done. What is the possibility of future progression? now bp is controlled with antihypertensive medicines alongwith statin. Male having age 60 yrs. No diabetes. Creatinine is 1.85, urea 43 , uric acid 8.00 , hemoglobin 12.5. Feb 2022 ->creatinine 1.13. now in July 2022 --> creatinine is 1.85. left kidney size is 9.30 cm and right is 9.00 cm
Hi I’m curious as I first developed symptoms for FMD soon after having a flu vaccination in 2001. I was extremely sick after the vaccination, losing the strength in my left arm and it impeded my ability to walk. My legs would freeze and I’d have to use my hand to physically lift my leg to initiate movement. This went on for about 4 weeks. My blood test showed ganglia cells and I was told that something was attacking my cells. What percentage of people with FMD have had a flu vaccination and has this ever been looked into as having any relation to FMD?
It is often claimed that a highly specific test is effective at ruling in a disease when positive, while a highly sensitive test is deemed effective at ruling out a disease when negative.
Hii My name is ashish and i am 19 years old, 3 years ago i have a stenosis in right renal artery but now i have in both arteries. What is its reason fat or fibromuscular dysplasia.
Its not very sensitive, meaning a negative bruit DOES NOT mean the pt. DOES NOT have RAS. It is highly specific, meaning that if the pt. DOES have a renal artery bruit, they most likely do have RAS. If the test were HIGHLY SENSITIVE, the lack of a bruit would mean NO RAS.
If a sensitive test comes back negative we can reliably exclude the disease.
If a specific test comes back positive we can be confident that we have a diagnosis.
Perfect 👍
You got it!
You’re awesome 👏
@@MedicosisPerfectionalis I didn't understand specific vs sensitive
Thanks!
You’re always welcome 🙏
My daughter was diagnosed with this when she was 5, after she was found to have a high bp. The high bp was found during routine observations for something else. She had an angioplasty a couple of months later, and her blood pressure has mostly stayed at normal levels. The stenosis was due to Neurofibromatosis type 1
How she is now??
@@viskklal she is doing well. her blood pressure has been a bit up and down in recent months but they are not worried currently
Hello, I’m surprised that someone as young as 5 has this already. I’m so sorry. I was diagnosed 7 months ago because I went to the hospital with a nose bleed that wouldn’t stop and my blood pressure was 165/144. I now am on bp meds twice a day and have my blood taken every other month and see a nephrologist every 6 months. Do you think your daughter will have the surgery to open up the artery?
@@lajewel4615 She had surgery a couple of months after diagnosis to open up the artery via an angioplasty procedure. She has just turned 6 at the time.
She is now 10. Her blood pressure is mostly stable but she can have peroids where it goes high, and she gets monitored, but overall she is doing well.
She also sees nephrology every 6 months.
@@lisylou247due to renal artery stenosis your daughter kidney was of normal size or kidney shrinking occur
Excellent video! I needed a refresher on just the basics of RAS, and I clicked on your video, and couldn't be more impressed and satisfied. THank you.
Thank you so much 😊
I've got RAS and I've been referred to the hospital, this has really helped me a lot in understanding what is happening to me..... Thank you
You're welcome!
I wish you the best!
Have u got pain during this test
Bro, make all videos open for us.
Your lecture and way of teaching is just superb❤
specific tests rule in. sensitive tests rule out.
+x Perfect
Thank you for covering this topic
My pleasure 😇
Grazie mile medocosis sharaxaadada iyo davidson book waa isku mid 🥰
Thank you for explaining
You're welcome!
I don't understand what you mean but specific test exclude other causes whereas sensitive test is positive in the disease as well as many other diseases
For example ESR is sensitive in rheumatic fever but not specific as it is positive also in many other diseases
ACEI is contraindicated in B/l renal artery stenosis. But can be used in u/l renal artery stenosis. Can you explain sir?
They have reduced renal perfusion due to atherosclerotic blockage. In patients with bilateral renal artery stenosis, the reduced systemic pressure (when given ACEI) is no longer able to overcome the stenosis and renal blood flow drops. ACEI also relatively dilate the efferent arteriole. These patients are dependent on angiotensin II efferent arteriole vasoconstriction in order to maintain GFR.
Although patients with bilateral RAS are at risk for acute kidney failure, most patients can tolerate the medication with only a minor rise in serum creatinine (
@@cardamomes in such case, ACE & RENIN is still inhibited. That will lead to diabetic insipidus in which ANP & BNP will regulate afferent dilation with efferent constriction. With lots of NA++ secretion , Adenosine & Adrenaline will maintain GFR raising SVR till prostaglandin kicks in dilating both afferent & efferent . Then Dopamine kicks in to decrease SVR back in & regulating glucocoticoid to decrease inflammation back to normal lumen !
@@ThatsWhy- Great!
Water pipe when constricted increases flow of water(Formula:A1V1=A2V2). But blood vessels when constricted decreases flow of blood. Because density increases more than decrease in Area (here formula changes to D1A1V1=D2A2V2.
D=density,A=Area,V=Velocity.)
Am I correct??
why does flush pulmonary edema occur in RAS patients
Exclude the disease (doppler for renal vessels)
If blockage is less than 50% at ostium of right renal artery only. Stent can't be done. What is the possibility of future progression? now bp is controlled with antihypertensive medicines alongwith statin. Male having age 60 yrs. No diabetes. Creatinine is 1.85, urea 43 , uric acid 8.00 , hemoglobin 12.5. Feb 2022 ->creatinine 1.13. now in July 2022 --> creatinine is 1.85. left kidney size is 9.30 cm and right is 9.00 cm
حفظت صوته من كثر ما اتابعه 😭😂😂
Haha 😂
Thank you for sharing your knowledge, may God bless you 🌹
Really good lecture👍😊
Thank you 🙏
40-50% stenosis what to do
Question; is renal hypertension primary or secondary? Also give reasons. Am kind of confused at the moment
great thanks 👌
My pleasure 😇
high sensitive rule out , true positiv against false positive
Hi I’m curious as I first developed symptoms for FMD soon after having a flu vaccination in 2001. I was extremely sick after the vaccination, losing the strength in my left arm and it impeded my ability to walk. My legs would freeze and I’d have to use my hand to physically lift my leg to initiate movement. This went on for about 4 weeks. My blood test showed ganglia cells and I was told that something was attacking my cells. What percentage of people with FMD have had a flu vaccination and has this ever been looked into as having any relation to FMD?
Great ❤️
High sensitivity test Includes the disease.
High specificity excludes the disease.
No...It’s the other way around.
It is often claimed that a highly specific test is effective at ruling in a disease when positive, while a highly sensitive test is deemed effective at ruling out a disease when negative.
@@MedicosisPerfectionalis yes you r right indeed😉
Hii
My name is ashish and i am 19 years old, 3 years ago i have a stenosis in right renal artery but now i have in both arteries. What is its reason fat or fibromuscular dysplasia.
How much ur serum creatinine
I have both fibromuscular dysplasia and atherosclerosis and renal artery stenosis.. im 21
Please follow up with a good doctor who is good at genetics…There may or may not be other manifestations to an underlying genetic disorder.
Fantastic lecture
you're amazing
Thank you 🙏
renal infarction video plzzzz
Ok
sensitive includes the disease
No, it excludes.
Thanks
You’re always welcome 🙏
My dad died from Renal Artery Stenosis
Include
Its not very sensitive, meaning a negative bruit DOES NOT mean the pt. DOES NOT have RAS. It is highly specific, meaning that if the pt. DOES have a renal artery bruit, they most likely do have RAS. If the test were HIGHLY SENSITIVE, the lack of a bruit would mean NO RAS.
Rule out
I have this :(
I am so sorry
I was 20 years old, I'm a guy and I had to have my kidney removed due to renal stenosis
how are you doing now?
sensitive means true positive so test positive means disease positive