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Renal ischemia X-ray

Renal ischemia associated with hypertension. Diminished size of the right kidney (A) due to renal artery stenosis (B) (arrow).

In the category of Small, smooth kidney.It shows Unilateral delayed appearance and excretion of contrast material with subsequent hyperconcentration.
There may be ureteral notching (due to collateral arteries) and vascular calcification.

Note : Chronic ischemia (usually arteriosclerosis or fibromuscular hyperplasia) causes tubular atrophy and shrinkage of glomeruli. Often associated with hypertension, which is likely if the right kidney is at least 2 cm shorter than the left or if the left kidney is at least 1.5 cm shorter than the right. May be bilateral if there is generalized renal arteriosclerosis.