Atherosclerotic ischemic renal vascular disease: do published outcomes justify the overzealous diagnostic approaches?
Atherosclerotic renal vascular disease is being recognized more frequently in an elderly patient population with chronic kidney disease. It also is much easier to diagnose and treat, at this time, because of the wide availability of coronary angiography and other radiologic imaging studies. In general, patients with atherosclerotic ischemic renal vascular disease are much sicker than the usual ESRD patient with more cardiac comorbidity and higher mortality rates. It is important to determine whether the lesions in the renal artery are physiologically significant before performing an intervention. The interventions are often risky with significant morbidity. Nephrologists should guide their colleagues to follow prudent courses of action. There are no evidence-based guidelines in this area.
Mailloux
Lionel U
LU
New York Universiy School of Medicine, American Society of Hypertension, Port Washington, NY 11050, USA. lionel1216@aol.com
D001161:Arteriosclerosis / Q000175:diagnosis* / Q000628:therapy; D006801:Humans; D006978:Hypertension, Renovascular / Q000175:diagnosis* / Q000628:therapy; D007676:Kidney Failure, Chronic / Q000209:etiology; D017063:Outcome Assessment, Health Care; D012078:Renal Artery Obstruction / Q000175:diagnosis* / Q000628:therapy