[Renovascular disease: challenge to general practitioners and internists].
Renovascular disease is defined as renal insufficiency secondary to fibromuscular or atherosclerotic renal artery stenosis. The immediate cause of renal insufficiency is not hypertension but ischemia and hyper-reninaemia that result from critical (greater than 80%) renal artery stenosis. Hyper-reninaemia damages also the contra lateral non-ischemic kidney. The key to successful treatment of renovascular disease is its diagnosis before the onset of renal insufficiency (> 180-200 micromol/l serum creatinine). The goal of interventional therapy is the prevention of symptomatic renal insufficiency and end-stage renal failure; the indication for intervention is the presence of greater than 80-85% renal artery stenosis. Patients diagnosed with non-critical renal artery stenosis (< 80%) do not need immediate intervention, only close follow-up.
Simon
Géza
G
Magyar Máltai Szeretet Szolgálat, Bem Rakparti Rendelo, Budapest. simon016@tc.umn.edu
D050197:Atherosclerosis / Q000150:complications; D005194:Family Practice; D005352:Fibromuscular Dysplasia / Q000150:complications; D006801:Humans; D007388:Internal Medicine; D007676:Kidney Failure, Chronic / Q000209:etiology* / Q000517:prevention & control; D012078:Renal Artery Obstruction / Q000150:complications* / Q000175:diagnosis*