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Renovascular disease causes

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

Causes

  • Atherosclerotic Renal Artery Stenosis (ARAS)[1] [2]
    • Atherosclerosis accounts for approximately 90% of the cases of RAS and is the predominant lesion detected in patients >50 years of age
    • The presence and number of diseased coronary arteries predicts the likelihood of ARAS
    • RAS resulting from atherosclerotic disease is common in (18% to 20%) individuals undergoing coronary angiography (1)
    • RAS resulting from atherosclerotic disease is even more common (35% to 50%) in individuals undergoing peripheral vascular angiography for occlusive disease of the aorta and legs (2)
  • Fibromuscular dysplasia
    • Unknown etiology
    • Second most common cause of RAS
    • Affects middle-aged women
    • More common in first-degree relatives and in the presence of the ACE-I allele.
    • Renal artery involvement is seen in 60% of cases – frequently bilateral compromise.
    • Progressive renal stenosis is seen in 37% of cases and loss of renal mass in 63%
  • Nephroangiosclerosis (HTN injury)
  • Diabetic Nephropathy (small vessels)
  • Renal thromboembolic disease
  • Atheroembolic renal disease
  • Aortorenal dissection
  • Post renal transplant RAS
  • Renal artery vasculitis
  • Trauma
  • Neurofibromatosis
  • Thromboangiitis obliterans
  • Scleroderma

References

  1. Rihal CS, Textor SC, Breen JF, McKusick MA, Grill DE, Hallett JW; et al. (2002). “Incidental renal artery stenosis among a prospective cohort of hypertensive patients undergoing coronary angiography”. Mayo Clin Proc. 77 (4): 309–16. doi:10.1016/S0025-6196(11)61782-5. PMID 11936924.
  2. Olin JW (2002). “Atherosclerotic renal artery disease”. Cardiol Clin. 20 (4): 547–62, vi. PMID 12472042.


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