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Review
. 2018 Nov;72(5):1023-1030.
doi: 10.1161/HYPERTENSIONAHA.118.11082.

Emerging Paradigms in Chronic Kidney Ischemia

Alfonso Eirin  1 , Stephen C Textor  1 , Lilach O Lerman  1   2
Affiliations
Review

Emerging Paradigms in Chronic Kidney Ischemia

Alfonso Eirin et al. Hypertension. 2018 Nov.
No abstract available

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Figures

Figure 1.
Figure 1.
The conventional paradigm. Renovascular disease (RVD) has been largely considered a hemodynamic condition, in which progressive occlusion of the renal vessels produces renovascular hypertension (RVH), renal hypoperfusion, and hypoxia, ultimately leading to chronic renal ischemia.
Figure 2.
Figure 2.
Evolving paradigms. New paradigms in the pathogenesis and treatment of renovascular disease (RVD) include transition from “hemodynamic” to “inflammatory” RVD, hypoxia, acute kidney insults (AKI), tissue injury, and renovascular hypertension (RVH), the implicate the contralateral kidney (CLK), renal microvascular remodeling, microRNAs, and mitochondrial injury.
Figure 3.
Figure 3.
Microvascular remodeling and loss in swine renovascular disease. Representative 3-D micro-CT images of the cortical and medullary microcirculation from normal (left) and stenotic (right) swine kidneys. The number of microvessels is reduced in the stenotic kidney, and vessel tortuosity is more pronounced, suggesting vascular immaturity.
Figure 4.
Figure 4.
Novel therapeutic approaches. Experimental therapeutic interventions targeting the pathoechanisms of renovascular disease (RVD) include optimized medical therapy, including renin-angiotensin-aldosterone system (RAAS) blockade, as well as statins, anti-inflammatory and antioxidant interventions, angiogenic factors, percutaneous transluminal renal angioplasty (PTRA), and mitoprotective drugs.
See this image and copyright information in PMC

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