Management of atherosclerotic renovascular disease: the effect of renal artery stenting on renal function and blood pressure

Abstract

In the last few years, renal artery stenting has gradually evolved into one of the most important therapeutic modalities in the management of atherosclerotic renovascular disease. Stenting is nowadays preferred by a steadily increasing number of physicians, not only because of its significant contribution to blood pressure control, but also because of its documented ability to maintain, and even improve, renal function. At the same time, procedure-related morbidity and mortality rates are extremely low, while recurrent stenosis rates have been repeatedly reported to be minimal. Percutaneous transluminal renal angioplasty (PTRA) and stenting are nowadays considered by many physicians to be the treatment of choice for atherosclerotic renovascular disease.

Nephrotic range proteinuria associated with unilateral renal artery stenosis

“…Correction of stenosis, with subsequent improvement in renal hemodynamic and hormonal alterations, can potentially lead to a substantial decrease in proteinuria [7].…”

The Management of Atherosclerotic Renovascular Disease

“…In several case series, patients whose renal function had been declining before intervention had impressive rates of better renal function afterward [42][43][44] . Muray et al [45] found in a prospective cohort study that a rise in serum creatinine before intervention seems to predict an improvement in renal function after revascularization.…”