Managing renal arterial disease and hypertension

Research output: Contribution to journalReview article

19 Scopus citations

Abstract

Treating patients with renovascular disease is complex, particularly as imaging and medical techniques become more effective. Atherosclerotic renal artery disease is present in 7% of the general population above age 65 and in 20 to 45% of patients with coronary disease or aortoiliac disease. Most patients are treated medically, but when progressive hypertension, renal insufficiency, or circulatory congestion develops, revascularization should be considered. Endovascular procedures with arterial stents are now widely employed. These procedures sometimes offer major benefits in blood pressure control and stabilization of renal function. Stent procedures continue to entail hazards, including atheroemboli, arterial dissections, and thrombosis, in addition to restenosis rates of 14 to 20%. Small, randomized trials to date demonstrate no survival benefit to either endovascular or surgical revascularization as compared with medical management. Recognizing renal artery disease and directing revascularization procedures to those with the most benefit remains a premier challenge for the clinician.

Original languageEnglish (US)
Pages (from-to)260-267
Number of pages8
JournalCurrent opinion in cardiology
Volume18
Issue number4
DOIs
StatePublished - Jul 1 2003

Keywords

  • Angioplasty
  • Hypertension
  • Ischemic nephropathy
  • Renal artery stenosis
  • Stent

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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