Renovascular Hypertension

Mark, Patrick B.; Schiffrin, Ernesto L.; Jennings, Garry; Dominiczak, Anna F.; Wang, Ji‐Guang; Buyzere, Marc De; Staessen, Jan A.

doi:10.1161/hypertensionaha.114.04497

Cited by 3 publications

(2 citation statements)

References 12 publications

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“…Hence, endovascular revascularization procedures for ARVD have fallen substantially over the last decade. These trial data are at odds with clinical experience and adverse outcomes after renal artery occlusion reported for some patients (1, 2). Additional reports identify specific high-risk patient subgroups with major clinical benefits with revascularization (3–5).…”

Section: Introductionmentioning

confidence: 87%

“…Reports of successful renal revascularization regularly provide examples of individuals with pivotal recovery of renal function or relief from pulmonary edema, most often in patients that were underrepresented in the relatively small, prospective trials conducted up to now. (1, 2, 5). An example of such a patient is illustrated in FIGURE 3, depicting creatinine values and BP information for over several years when the role of ARVD was overlooked for several years.…”

Section: “Evidence-biased Medicine?”mentioning

confidence: 99%

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Renal artery stenosis

Textor

McKusick

2016

Current Opinion in Nephrology and Hypertension

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Purpose Atherosclerotic renovascular disease remains highly prevalent and presents an array of clinical syndromes. Recent prospective trials have dampened enthusiasm for revascularization generally, but clinicians recognize the need to identify patients likely to benefit from vascular intervention. Recent findings highlight the inflammatory nature of vascular occlusive disease and the limits of the kidney to adapt to reduced blood flow. Although moderate reductions can be tolerated, severe impairment of renal perfusion leads to tissue hypoxia and activates inflammatory injury within the kidney. Hence, assessment of kidney viability and potential tools to modify mitochondrial and inflammatory damage may be important to identify patients for whom clinical intervention should be undertaken. Implications for practice Clinicians must recognize clinical syndromes that identify “high-risk” groups and apply revascularization in those likely to benefit. Future efforts to protect the kidney (e.g. mitochondrial protection) and/or cell-based therapy may amplify the clinical recovery when combined with restoring renal blood flow.

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Section: Introductionmentioning

confidence: 87%

Section: “Evidence-biased Medicine?”mentioning

confidence: 99%