TY - JOUR
T1 - Renal artery stenosis
T2 - Medical versus interventional therapy topical collection on hypertension
AU - Textor, Stephen C.
AU - Lerman, Lilach O.
N1 - Copyright:
Copyright 2021 Elsevier B.V., All rights reserved.
PY - 2013/10
Y1 - 2013/10
N2 - Reports from recent trials indicate little additional benefit from stent supported revascularization in patients with atherosclerotic renal artery stenosis. These data have been questioned, particularly on the basis of including subjects with modest occlusive disease and reports of clinical benefits to patients with episodic congestive heart failure. Nonetheless, these data have moved the pendulum away from renal revascularization as a primary maneuver to one reserved for refractory hypertension and/or progressive loss of renal function and circulatory congestion. Recent data emphasize the limits of the kidney adaptation to reduced blood flow, the eventual development of widespread renal hypoxia with activation of inflammatory and fibrogenic pathways. Experimental data now support developing adjunctive measures to support angiogenesis and anti-inflammatory renal repair mechanisms, such as those observed with cell-based therapy with mesenchymal stem/stromal cells.
AB - Reports from recent trials indicate little additional benefit from stent supported revascularization in patients with atherosclerotic renal artery stenosis. These data have been questioned, particularly on the basis of including subjects with modest occlusive disease and reports of clinical benefits to patients with episodic congestive heart failure. Nonetheless, these data have moved the pendulum away from renal revascularization as a primary maneuver to one reserved for refractory hypertension and/or progressive loss of renal function and circulatory congestion. Recent data emphasize the limits of the kidney adaptation to reduced blood flow, the eventual development of widespread renal hypoxia with activation of inflammatory and fibrogenic pathways. Experimental data now support developing adjunctive measures to support angiogenesis and anti-inflammatory renal repair mechanisms, such as those observed with cell-based therapy with mesenchymal stem/stromal cells.
KW - Angioplasty
KW - Chronic kidney disease
KW - Congestive heart failure
KW - Interventional therapy
KW - Medical therapy
KW - Mesenchymal stem cells
KW - Renal artery stenosis
KW - Stent
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U2 - 10.1007/s11886-013-0409-8
DO - 10.1007/s11886-013-0409-8
M3 - Article
C2 - 23990274
AN - SCOPUS:84884910493
SN - 1523-3782
VL - 15
JO - Current cardiology reports
JF - Current cardiology reports
IS - 10
M1 - 409
ER -