Approach to atherosclerotic renovascular disease: 2016.
The management of atherosclerotic renal artery stenosis in patients with hypertension or impaired renal function remains a clinical dilemma. The current general consensus, supported by the results of the Angioplasty and Stenting for Renal Atherosclerotic Lesions and Cardiovascular Outcomes for Renal Artery Lesions trials, argues strongly against endovascular intervention in favor of optimal medical management. We discuss the limitations and implications of the contemporary clinical trials and present our approach and formulate clear recommendations to help with the management of patients with atherosclerotic narrowing of the renal artery.
Renal Division, Department of Internal Medicine , Washington University School of Medicine , 660 South Euclid, Box 8126, St Louis, MO 63110 , USA.
Reem
R
Daloul
Renal Division, Department of Internal Medicine , Washington University School of Medicine , 660 South Euclid, Box 8126, St Louis, MO 63110 , USA.
Aubrey R
AR
Morrison
CKD; atherosclerosis; chronic renal insufficiency; hypertension; renal artery stenosis
Ann Intern Med. 2009 Jun 16;150(12):840-8, W150-1
19414832
Curr Opin Nephrol Hypertens. 2014 Nov;23(6):525-32
25160077
J Vasc Surg. 1990 Sep;12 (3):227-36
2204735
Prog Cardiovasc Dis. 2009 Nov-Dec;52(3):196-203
19917330
Am J Kidney Dis. 2014 Feb;63(2):186-97
24074824
J Am Coll Cardiol. 2003 Jan 1;41(1):47-55
12570944
Vasc Med. 2002;7(4):275-9
12710843
Blood Press. 2011 Feb;20(1):15-9
21034349
Eur Heart J. 2011 Nov;32(22):2851-906
21873417
BMJ Case Rep. 2012 Aug 13;2012:null
22891024
Clin J Am Soc Nephrol. 2014 Feb;9(2):395-405
24370767
Arterioscler Thromb Vasc Biol. 2004 Oct;24(10):1854-9
15308558
Klin Wochenschr. 1990 Aug 17;68(16):830-4
2214605
Nephron Physiol. 2014 Nov 27;:null
25471091
Invest Radiol. 2009 Sep;44(9):566-71
19668000
Curr Opin Nephrol Hypertens. 2016 Mar;25(2):144-51
26741885
Circ Cardiovasc Interv. 2013 Aug;6(4):428-35
23899868
Kidney Int. 1984 Oct;26(4):375-83
6396435
Heart. 2000 Feb;83(2):152-5
10648486
Surgery. 1963 Apr;53:513-24
13934072
Kidney Int. 1991 Jun;39(6):1232-9
1895675
J Am Coll Cardiol. 2006 Nov 7;48(9):1851-5
17084261
N Engl J Med. 2014 Jan 2;370(1):13-22
24245566
Clin J Am Soc Nephrol. 2014 Jun 6;9(6):1117-23
24408123
Ann Intern Med. 1993 May 1;118(9):712-9
8460859
Br Med Bull. 2005 Sep 07;73-74:35-55
16148190
Lancet. 1988 Sep 3;2(8610):551-2
2900930
Am Heart J. 1998 Nov;136(5):913-8
9812088
J Vasc Interv Radiol. 2008 Nov;19(11):1563-8
18954765
J Vasc Surg. 1992 Jan;15(1):73-80; discussion 80-2
1728693
Clin J Am Soc Nephrol. 2012 Feb;7(2):224-30
22193234
Urol Clin North Am. 1984 Aug;11(3):383-92
6464247
Circulation. 2002 Aug 27;106(9):1165-71
12196346
Lancet. 1994 Jul 23;344(8917):237-9
7913161
J Vasc Surg. 1996 Mar;23 (3):428-35
8601884
J Am Soc Nephrol. 2015 Sep;26(9):2074-80
25868641
Kidney Int. 2005 Jul;68(1):293-301
15954920
Hypertension. 1998 Mar;31(3):823-9
9495267
Hypertension. 2010 Sep;56(3):525-32
20625080
J Vasc Interv Radiol. 2014 Apr;25(4):511-20
24325931
J Vasc Surg. 2012 Oct;56(4):1052-9, 1060.e1; discussion 1059-60
22595689
Hypertension. 2010 Apr;55(4):961-6
20194303
N Engl J Med. 2000 Apr 6;342(14 ):1007-14
10749962
Kidney Int. 2004 Jan;65(1):251-8
14675057
Kidney Int. 2001 Oct;60(4):1490-7
11576364
J Vasc Surg. 1994 Feb;19(2):250-7; discussion 257-8
8114186
Eur Radiol. 2001;11(12 ):2524-30
11734953
J Am Soc Hypertens. 2016 Apr;10 (4):325-35
26879682
Ann Intern Med. 1985 Mar;102(3):308-14
3970470
Am J Kidney Dis. 2002 Jan;39(1):60-6
11774103
Hypertension. 2011 Dec;58(6):1066-72
22042812
Prog Cardiovasc Dis. 2009 Nov-Dec;52(3):249-59
19917337
Semin Dial. 2009 Sep-Oct;22(5):519-23
19558627
Am J Hypertens. 2014 Aug;27(8):1000-3
25103928
AJR Am J Roentgenol. 2007 Mar;188(3):798-811
17312071
J Vasc Surg. 2002 Sep;36(3):443-51
12218965
J Hum Hypertens. 1998 May;12(5):329-35
9655655
J Am Soc Nephrol. 2008 Apr;19(4):656-9
18235081
Nephrol Dial Transplant. 2010 Mar;25(3):813-20
19666661
Circulation. 2006 Mar 21;113(11):e463-654
16549646
Am J Nephrol. 2014;40(5):468-77
25503847
J Am Soc Hypertens. 2016 Apr;10 (4):360-7
26944791
J Clin Hypertens (Greenwich). 2014 Jul;16(7):497-503
24909590
N Engl J Med. 2009 Nov 12;361(20):1953-62
19907042
Eur Heart J. 2008 Feb;29(4):517-24
18276621
J Vasc Interv Radiol. 2002 Oct;13(10):959-74
12397117