Renal Artery Stenosis Follow-up

Updated: Nov 02, 2020
  • Author: Bruce S Spinowitz, MD, FACP; Chief Editor: Vecihi Batuman, MD, FASN  more...
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Follow-up

Further Outpatient Care

In view of the natural history of RVD, patients require serial determinations of serum creatinine levels. Adequate blood pressure control is required, with monitoring of serum potassium levels as necessary. Duplex ultrasound, if available, allows regular follow-up of radiologic progression.

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Prognosis

Researchers have studied the natural history of atherosclerotic renal artery stenosis by obtaining images from sequential abdominal aortographs or duplex ultrasound scans in patients with documented renal artery lesions who have been treated medically. Most studies show that progressive arterial obstruction occurs in 42-53% of patients with atherosclerotic renal artery stenosis, often within the first 2 years of radiographic follow-up. The incidence rate of progression to complete renal artery occlusion in these studies ranges from 9-16%; this often occurs in patients with a high-degree stenosis. In a study of 85 patients at the Cleveland Clinic who were followed for 3-172 months, patients with mild-to-moderate stenosis remained unchanged upon follow-up, and 39% of patients with greater than 75% lesions progressed to total occlusion. [60]

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