2015
DOI: 10.1681/asn.2014121274
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Paradigm Shifts in Atherosclerotic Renovascular Disease

Abstract: Results of recent clinical trials and experimental studies indicate that whereas atherosclerotic renovascular disease can accelerate both systemic hypertension and tissue injury in the poststenotic kidney, restoring vessel patency alone is insufficient to recover kidney function for most subjects. Kidney injury in atherosclerotic renovascular disease reflects complex interactions among vascular rarefication, oxidative stress injury, and recruitment of inflammatory cellular elements that ultimately produce fibr… Show more

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Cited by 63 publications
(35 citation statements)
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“…They emphasize the importance of pursuing novel strategies to reverse inflammatory and profibrotic injury in ARAS as we have proposed (25).…”
Section: Discussionmentioning
confidence: 91%
“…They emphasize the importance of pursuing novel strategies to reverse inflammatory and profibrotic injury in ARAS as we have proposed (25).…”
Section: Discussionmentioning
confidence: 91%
“…First, mitochondrial dysfunction in kidney cells has been implicated in the pathogenesis of CKD [3][4][5] and proposed as a therapeutic target for atherosclerotic renovascular disease. 8,17 Mitochondrial dysfunction can be a consequence of oxidative stress. 18 In functional studies, exposure to hydrogen peroxide, a reactive oxygen species, resulted in damage to the DNA replication enzyme (polymerase g) in the mitochondria and a reduction in mtDNA copy number.…”
Section: Main Findingsmentioning
confidence: 99%
“…Indeed, although less revascularization procedures have been performed per year in the post-ASTRAL period compared to earlier years, the percentage of newly diagnosed ARVD patients who undergo revascularization is significantly higher in this last cohort, reflecting a selected population. Forgoing investigations for ARVD may be the correct option in the large majority of patients in whom revascularization will not lead to benefit, either due to functionally insignificant RAS [24] or irreversible renal parenchymal injury [25]. However, there is a concern that reduced enthusiasm for investigation may lead to missed opportunities for timely diagnosis of ARVD [9].…”
Section: Discussionmentioning
confidence: 99%