Renal insufficiency and renal artery disease in the critically ill

Changes in mortality trends in coronary and cerebrovascular disease over the past two decades have led to more patients reaching advanced age with widespread atherosclerotic disease than ever before. Hence, clinicians must be aware of the rising prevalence of renal artery disease leading to syndromes of deteriorating blood pressure control, renal dysfunction, episodic "flash" pulmonary edema, and occasionally, end-stage renal failure. Prompt recognition of these disorders, use of emerging vascular imaging techniques and renal revascularization, when appropriate, are crucial to successful treatment of patients with renal failure due to renovascular disease.