Renovascular disease
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Renovascular disease is disease of the renal arteries and veins. It is a progressive disease causing narrowing of the arteries and veins of kidneys.
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Historical Perspective
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Pathophysiology
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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
- ↑ 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.
- ↑ Olin JW (2002). “Atherosclerotic renal artery disease”. Cardiol Clin. 20 (4): 547–62, vi. PMID 12472042.
Differentiating Renovascular disease from other Diseases
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Epidemiology and Demographics
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
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Overview
Epidemiology and Demographics
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Prevalence of Renal Artery Stenosis -
Prevalence RAS at Cardiac Cath
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Risk Factors
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Screening
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Natural History, Complications and Prognosis
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
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Overview
Natural History
Complications
- Renovascular hypertension[1]
- Ischemic Nephropathy
- Accelerated CV Disease
- Congestive Heart Failure
- Stroke
- Secondary aldosteronism
Prognosis
References
- ↑ Garovic VD, Textor SC (2005). “Renovascular hypertension and ischemic nephropathy”. Circulation. 112 (9): 1362–74. doi:10.1161/CIRCULATIONAHA.104.492348. PMID 16129817.
Diagnosis
Diagnosis
History and Symptoms | Physical Examination | Laboratory Findings | Electrocardiogram | Chest X Ray | CT | MRI | Echocardiography or Ultrasound | Other Imaging Findings | Other Diagnostic Studies
Treatment
Treatment
Medical Therapy | Surgery | Primary Prevention | Secondary Prevention | Cost-Effectiveness of Therapy | Future or Investigational Therapies
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