Renovascular hypertension: Is there still a role for stent revascularization

Research output: Contribution to journalArticle

9 Citations (Scopus)

Abstract

PURPOSE OF REVIEW: Management of renovascular hypertension remains controversial and problematic, in part, due to failure of prospective trials to demonstrate added benefit to revascularization. RECENT FINDINGS: Effective drug therapy often can achieve satisfactory blood pressure control, although concerns persist of the potential for progressive, delayed loss of kidney function beyond a stenotic lesion. Recent studies highlight benefits of renal artery stenting in subsets of patients including those with recurrent pulmonary edema and those intolerant to blockade of the renin-angiotensin system. Occasional patients with recent deterioration in renal function recover sufficient glomerular filtration rate after stenting to avoid requirements for renal replacement therapy. Emerging paradigms from both clinical and experimental studies suggest that hypoxic injury within the kidney activates inflammatory injury pathways and microvascular rarification that may not recover after technically successful revascularization alone. Initial data suggest that additional measures to repair the kidney, including the use of cell-based therapy, may offer the potential to recover kidney function in advanced renovascular disease. SUMMARY: Specific patient groups benefit from renal revascularization. Nephrologists will increasingly be asked to manage complex renovascular patients, different from those in randomized trials, that require intensely individualized management.

Original languageEnglish (US)
Pages (from-to)525-530
Number of pages6
JournalCurrent Opinion in Nephrology and Hypertension
Volume22
Issue number5
DOIs
StatePublished - Sep 2013

Fingerprint

Renovascular Hypertension
Stents
Kidney
Renal Replacement Therapy
Wounds and Injuries
Renal Artery
Pulmonary Edema
Renin-Angiotensin System
Cell- and Tissue-Based Therapy
Glomerular Filtration Rate
Blood Pressure
Drug Therapy

Keywords

  • hypertension
  • inflammation
  • mesenchymal stem cells
  • renal artery stenosis
  • stent
  • transforming growth factor-b

ASJC Scopus subject areas

  • Nephrology
  • Internal Medicine

Cite this

Renovascular hypertension : Is there still a role for stent revascularization. / Textor, Stephen C.

In: Current Opinion in Nephrology and Hypertension, Vol. 22, No. 5, 09.2013, p. 525-530.

Research output: Contribution to journalArticle

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