When we see abnormal serum creatinine, RAS is usually one of those DD we plant in the back of our minds, particularly if patients have other RF’s for plaque. The degree of stenosis can be estimated using renal US. Estimates of plaque can range from 10% to close to 100%. Is there any way to help prevent or slow the accumulation of plaque in the renal arteries? Since renal stenting and/or angioplasty comes with risks, how can we determine if a patient might truly need some sort of an intervention? Are there any other diagnostics that might help us?