Diagnosis and therapy of atheromatous renal artery stenosis

Abstract

Atheromatous renal artery stenosis (ARAS), a lesion of systemic atherosclerotic disease, is the leading cause of stenotic lesions in the renal artery, followed by fibromuscular dysplasia, a primary abnormality of the renal artery. As a result of several clinical trails, which failed to show an additional benefit of renal revascularization to medical therapy in ARAS, the treatment of ARAS has shifted, and renal revascularization is less commonly performed for ARAS. However, it is recognized that renal revascularization benefits some patients with ARAS. Advances in imaging modalities would allow more frequent detection of ARAS in a society with a growing elderly population, a group with an increased prevalence of systemic atherosclerotic disease. Therefore, it is imperative to identify the patients with ARAS who could benefit from renal revascularization. This review presents a strategy for the treatment of ARAS based on the results of our analysis.

Successful long-term effects of direct renin inhibitor aliskiren in a patient with atherosclerotic renovascular hypertension

“…The mechanism by which BP rises in RVH is explained by the activation of the renin-angiotensin-aldosterone system (RAAS) in the kidney due to renal ischemia originated from the narrowing of the renal artery [6]. The RAAS activation not only stimulates renin but also stimulates aldosterone, causing a mixture of renin-dependent and Abstract A 64-year-old man visited our hospital with complaints of misty vision and ophthalmalgia.…”