Atherosclerotic Renal Artery Stenosis: Should we Intervene Earlier?

被引：27

作者：

de Leeuw, Peter W. ^{[1
,2
]}

Postma, Cor T. ^{[3
]}

Spiering, Wilko ^{[4
]}

Kroon, Abraham A. ^{[1
]}

机构：

[1] Maastricht Univ, Med Ctr, Dept Med, Maastricht, Netherlands

[2] Zuyderland Med Ctr, Dept Med, Sittard Geleen, Heerlen, Netherlands

[3] Univ Med Ctr Nijmegen St Radboud, Dept Med, Nijmegen, Netherlands

[4] Univ Utrecht, Univ Med Ctr Utrecht, Dept Vasc Med, Utrecht, Netherlands

来源：

CURRENT HYPERTENSION REPORTS | 2018年 / 20卷 / 04期

关键词：

Atherosclerosis; Renovascular hypertension; Cardiovascular complications; Renal function; Renal artery stenosis; Intervention; TRANSLESIONAL PRESSURE-GRADIENTS; RENOVASCULAR DISEASE; NATURAL-HISTORY; VASCULAR-DISEASE; HYPERTENSION; REVASCULARIZATION; ANGIOGRAPHY; PREVALENCE; DYSFUNCTION; ULTRASOUND;

D O I：

10.1007/s11906-018-0829-3

中图分类号：

R6 [外科学];

学科分类号：

1002 ; 100210 ;

摘要：

Purpose of Review Randomized trials have failed to show clinical benefit in patients with atherosclerotic renal artery stenosis who were treated with angioplasty with or without stenting. However, these studies were done in patients with a high-grade stenosis. This paper examines whether there are arguments to consider patients with low-grade stenosis for angioplasty. Recent Findings Patients with low-grade (< 50%) atherosclerotic renal artery stenosis have an excess risk for cardiovascular and renal complications. This could be related to inflammatory factors being generated by the stenotic kidney. Moreover, even a kidney with low-grade stenosis clears less or produces more of the natural nitric oxide inhibitor ADMA. Summary Patients with low-grade atherosclerotic renal artery stenosis have an increased risk for a variety of complications. In addition, the abnormality is progressive. There is a case for setting up a prospective trial to examine whether angioplasty confers benefit in patients with low-grade renal artery stenosis.

引用

页数：7

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