Epidemiology of atherosclerotic renal artery stenosis as a mirror of prospective trials

Abstract

Diagnosis and treatment of atherosclerotic renal artery stenosis (ARAS) in the elderly is a never-ending challenge for every nephrologist. Kalra et al. report that adjusted hazard ratios for ARAS increased threefold from 1992 to 2004 in 16 million United States Renal Data System participants aged 66 years or older. However, numbers of revascularizations showed a biphasic pattern with a declining number since 1999. These exciting data have to be discussed with the knowledge of recent prospective trials.

Influence of Renal Artery Variants, Number, Location, and Degree of Renal Artery Stenoses on the Atherosclerotic Burden of the Aorta

“…1 Moreover, there is ongoing discussion as to whether endovascular therapy is preferable to medication or combined therapy. 2 Screening methods for RAS can be relatively insensitive 3–6 and sometimes underestimate the number 5,6 of additional or accessory renal arteries (ADRAs or ACRAs) from the aorta or its branches. 7 Just as the main vessels, these renal arteries, can be stenotic and thus cause arterial hypertension.…”

Nierenarterienstenose: Intervention oder medikamentöse Behandlung?

“…Sie tritt vor allem bei jungen Frauen auf und ist durch Stenosen im gesamten Verlauf der Nierenarterie charakteristiert [9]. [3,13]. Somit dürfte unser Patientenkollektiv typisch und in der Therapie vergleichbar sein mit den meisten Zentren.…”