Atherosclerotic ischemic renal disease

Atherosclerotic renal artery stenosis: is it worth diagnosing?

“…In a review of six series improvement and stabilisation of renal function occurred in 40 and 30% of patients respectively. 3 Major complications occurred in 3-10% and procedural mortality was 1-3%. In patients with renal failure renal artery stenting results in durable technical success.…”

“…22 Thirty percent are bilateral. 3 Not surprisingly this impacts on the success and complication rates of attempted revascularisation. In major centres surgical revascularisation is associated with a 95% technical success.…”

“…Perioperative mortality in this elderly atherosclerotic population is significant at 2.5-6%. 3 In view of this, percutaneous transluminal renal artery angioplasty (PTRA) was introduced. PTRA successfully dilates non-ostial ARAS in 75-94% of cases with a 1 year restenosis rate of 10-30%.…”

“…30 A recent review of eight surgical series indicated postoperative improvement in renal function in around half. 3 Despite the high rate of restenosis PTRA may also be of benefit. In a review of six series improvement and stabilisation of renal function occurred in 40 and 30% of patients respectively.…”

“…2 Where critical stenoses subtend the whole renal mass (bilateral disease or stenosis of a solitary functioning kidney) ARAS may lead to progressive ischaemic renal failure. 3 Prospective renal angiographic studies in patients starting dialysis over the age of 50 indicate ARAS to be the cause in 10-20% of cases. 4 Furthermore, it is implicated in a similar proportion of patients presenting with acute renal failure, usually in association with the introduction of angiotensin-converting enzyme inhibitors.…”