title: Mild Renal Artery Stenosis Can Induce Renovascular Hypertension and is Associated with Elevated Renal Vein Renin Secretion.
abstract: Renovascular hypertension is a syndrome which encompasses the physiological response of the kidney to changes in renal blood flow and renal perfusion pressure. Such physiological changes can occur with renal artery occlusion irrespective of the severity of the lesion. We have analyzed hypertensive patients with mild renal artery stenosis and compared them to patients with no stenosis. Renal vein renin sampling from catheterization of the renal vein was performed in all these patients. Patients with mild stenosis had higher renal vein renin ratio (3.01 ± 1.5) than the patients with no stenosis (1.10 ± 0.29; p = 0.002). Patients with mild stenosis were also found to have higher diastolic blood pressure and renal artery resistive indices when compared to patients with no stenosis. We therefore conclude that mild stenosis can precipitate renin-mediated hypertension in renovascular stenosis and also emphasis that parameters pertinent to renal physiology need to be evaluated before considering treatment options in patients with renal artery stenosis and medical management with RAAS blockade is the preferred modality of therapy for patients with renin-mediated hypertension.
authors.affiliation: Angiocare, Vascular and Interventional Nephrology, Tucson, Arizona; Department of Medicine, Nephrology Division, University of Arizona, Tucson, Arizona.
authors.forename: Saravanan
authors.initials: S
authors.lastname: Balamuthusamy
authors.forename: Arun
authors.initials: A
authors.lastname: Kannan
authors.forename: Bijin
authors.initials: B
authors.lastname: Thajudeen
authors.forename: Dean
authors.initials: D
authors.lastname: Ottley
authors.forename: Nishant
authors.initials: N
authors.lastname: Jalandhara
mesh_terms: D000368:Aged; D000792:Angiography; D001794:Blood Pressure; D005260:Female; D006801:Humans; D006978:Hypertension, Renovascular / Q000209:etiology*; D007668:Kidney / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D012078:Renal Artery Obstruction / Q000150:complications*; D012082:Renal Veins / Q000378:metabolism; D012083:Renin / Q000097:blood*; D012189:Retrospective Studies; D018616:Ultrasonography, Doppler, Duplex
chemical_list: D012083:Renin