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Review
. 2018 Apr 10;20(4):35.
doi: 10.1007/s11906-018-0829-3.

Atherosclerotic Renal Artery Stenosis: Should we Intervene Earlier?

Peter W de Leeuw  1   2 , Cor T Postma  3 , Wilko Spiering  4 , Abraham A Kroon  5
Affiliations
Review

Atherosclerotic Renal Artery Stenosis: Should we Intervene Earlier?

Peter W de Leeuw et al. Curr Hypertens Rep. .

Abstract

Purpose of review: Randomized trials have failed to show clinical benefit in patients with atherosclerotic renal artery stenosis who were treated with angioplasty with or without stenting. However, these studies were done in patients with a high-grade stenosis. This paper examines whether there are arguments to consider patients with low-grade stenosis for angioplasty.

Recent findings: Patients with low-grade (< 50%) atherosclerotic renal artery stenosis have an excess risk for cardiovascular and renal complications. This could be related to inflammatory factors being generated by the stenotic kidney. Moreover, even a kidney with low-grade stenosis clears less or produces more of the natural nitric oxide inhibitor ADMA. Patients with low-grade atherosclerotic renal artery stenosis have an increased risk for a variety of complications. In addition, the abnormality is progressive. There is a case for setting up a prospective trial to examine whether angioplasty confers benefit in patients with low-grade renal artery stenosis.

Keywords: Atherosclerosis; Cardiovascular complications; Intervention; Renal artery stenosis; Renal function; Renovascular hypertension.

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Conflict of interest statement

Conflict of Interest

The authors declare no conflicts of interest relevant to this manuscript.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

Figures

Fig. 1
Fig. 1
Reduced renal plasma clearance of ADMA by the stenotic kidney in patients with unilateral ARAS. Data from [17]
See this image and copyright information in PMC

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