Atherosclerotic Renal Artery Stenosis: Should we Intervene Earlier?

Peter W. de Leeuw*, Cor T. Postma, Wilko Spiering, Abraham A. Kroon

*Corresponding author for this work

Research output: Contribution to journal(Systematic) Review article peer-review

13 Citations (Web of Science)

Abstract

Purpose of Review Randomized trials have failed to show clinical benefit in patients with atherosclerotic renal artery stenosis who were treated with angioplasty with or without stenting. However, these studies were done in patients with a high-grade stenosis. This paper examines whether there are arguments to consider patients with low-grade stenosis for angioplasty. Recent Findings Patients with low-grade (< 50%) atherosclerotic renal artery stenosis have an excess risk for cardiovascular and renal complications. This could be related to inflammatory factors being generated by the stenotic kidney. Moreover, even a kidney with low-grade stenosis clears less or produces more of the natural nitric oxide inhibitor ADMA. Summary Patients with low-grade atherosclerotic renal artery stenosis have an increased risk for a variety of complications. In addition, the abnormality is progressive. There is a case for setting up a prospective trial to examine whether angioplasty confers benefit in patients with low-grade renal artery stenosis.
Original languageEnglish
Article number35
Number of pages7
JournalCurrent Hypertension Reports
Volume20
DOIs
Publication statusPublished - 1 Apr 2018

Keywords

  • Atherosclerosis
  • Renovascular hypertension
  • Cardiovascular complications
  • Renal function
  • Renal artery stenosis
  • Intervention
  • TRANSLESIONAL PRESSURE-GRADIENTS
  • RENOVASCULAR DISEASE
  • NATURAL-HISTORY
  • VASCULAR-DISEASE
  • HYPERTENSION
  • REVASCULARIZATION
  • ANGIOGRAPHY
  • PREVALENCE
  • DYSFUNCTION
  • ULTRASOUND

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