title: [Hypertension therapy in patients with renal artery stenosis].
abstract: Renovascular hypertension is due to reduced renal parenchymal perfusion. The correct diagnosis can be difficult. It is important to note that the demonstration of renal artery stenosis in a patient with hypertension does not necessarily constitute renovascular hypertension. Often, clinically nonsignificant and asymptomatic renal artery stenosis are found in patients with essential hypertension, or renal failure of other origin. Renovascular disease is a complex disorder with various clinical presentations. In patients with significant renovascular hypertension plasma renin is increased. For this reason the therapy aims to block the renin-angiotensin-aldosterone system. Bilateral renal artery stenosis causes renal sodium retention. In this situation a diuretic drug has to be added to the therapy. Endovascular or surgical therapy has to be considered in patients with flash pulmonary edema or fibromuscular dysplasia. The control of cardiovascular risk factors is important.
authors.affiliation: Service de Néphrologie et d'Hypertension, Département de Médecine, Centre Hospitalier Universitaire Vaudois CHUV, Université de Lausanne. bruno.vogt@chuv.ch
authors.forename: Bruno
authors.initials: B
authors.lastname: Vogt
authors.forename: Maillard
authors.initials: M
authors.lastname: Maillard
authors.forename: Michel
authors.initials: M
authors.lastname: Burnier
mesh_terms: D000959:Antihypertensive Agents / Q000009:adverse effects / Q000627:therapeutic use*; D001794:Blood Pressure / Q000187:drug effects; D004232:Diuretics / Q000627:therapeutic use; D005919:Glomerular Filtration Rate / Q000187:drug effects; D006801:Humans; D006978:Hypertension, Renovascular / Q000188:drug therapy*; D007668:Kidney / Q000098:blood supply; D012078:Renal Artery Obstruction / Q000188:drug therapy*; D012083:Renin / Q000097:blood; D012084:Renin-Angiotensin System / Q000187:drug effects; D012307:Risk Factors
chemical_list: D000959:Antihypertensive Agents; D004232:Diuretics; D012083:Renin