Renal Artery Stenosis Questions & Answers

Updated: Nov 02, 2020
  • Author: Bruce S Spinowitz, MD, FACP; Chief Editor: Vecihi Batuman, MD, FASN  more...
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Questions & Answers

Overview

What is renal artery stenosis (RAS)?

What are the signs and symptoms of renal artery stenosis (RAS)?

What is involved in the workup and management of renal artery stenosis (RAS)?

What is the pathophysiology of renal artery stenosis (RAS)?

Which factors affect the glomerular filtration rate (GFR) in the pathophysiology of renal artery stenosis (RAS)?

What is the effect of chronic ischemia in the pathophysiology of renal artery stenosis (RAS)?

What is the role of glomerular filtration rate (GFR) in the pathophysiology of renal artery stenosis (RAS)?

What degree of renal artery stenosis justifies an attempt at either surgical or radiologic intervention?

What are the risk factors for renal artery stenosis (RAS)?

What is the prevalence of renal artery stenosis (RAS) in the US?

What are the morbidities of renal artery stenosis (RAS)?

What are the racial predilections for renal artery stenosis (RAS)?

How does the prevalence of renal artery stenosis (RAS) vary by sex?

How does the prevalence of renal artery stenosis (RAS) vary by age?

Presentation

Which physical findings are characteristic of renal vascular disease (RVD) in renal artery stenosis (RAS)?

DDX

What are the differential diagnoses for Renal Artery Stenosis?

Workup

What is the role of serum creatinine testing in the workup of renal artery stenosis (RAS)?

What is the role of 24-hour urine collection in the workup of renal artery stenosis (RAS)?

What is the role of urinalysis in the workup of renal artery stenosis (RAS)?

What is the role of serologic tests in the workup of renal artery stenosis (RAS)?

What is the role of renin-angiotensin system assessment in the workup of renal artery stenosis (RAS)?

What is the role of peripheral renin activity in the diagnosis of renal artery stenosis (RAS)?

What is the role of blood oxygen level–dependent (BOLD) MRI in the workup of renal artery stenosis (RAS)?

What is the role of ultrasonography in the workup of renal artery stenosis (RAS)?

What is the role of radionuclide scanning in the workup of renal artery stenosis (RAS)?

What is the role of spiral angiography in the workup of renal artery stenosis (RAS)?

What is the role of magnetic resonance angiography (MRA) in the workup of renal artery stenosis (RAS)?

What are concerns regarding gadolinium use in imaging studies for the diagnosis of renal artery stenosis (RAS)?

What is the efficacy of magnetic resonance angiography (MRA) in the workup of renal artery stenosis (RAS)?

What is the role of conventional angiography in the workup of renal artery stenosis (RAS)?

What are the advantages of conventional aortography in the workup of renal artery stenosis (RAS)?

What is the role of IV subtraction angiography in the workup of renal artery stenosis (RAS)?

What are the advantages of intra-arterial digital subtraction angiography in the workup of renal artery stenosis (RAS)?

What is the role of carbon dioxide angiography in the workup of renal artery stenosis (RAS)?

What causes contrast nephrotoxicity in the workup of renal artery stenosis (RAS)?

How are diagnostic tests selected for renal artery stenosis (RAS)?

How does conventional angiography compare to gadolinium-enhanced magnetic resonance angiography (MRA) for the diagnosis of renal artery stenosis (RAS)?

What is the significance of an incidental finding of atherosclerotic renovascular disease during the evaluation of renal artery stenosis (RAS)?

Treatment

What is the role of revascularization in the treatment of renal artery stenosis (RAS)?

What are the criteria for observation instead of revascularization in treatment of renal artery stenosis (RAS)?

What are the prerequisites for revascularization in the treatment of renal artery stenosis (RAS)?

What are the indications for conservative treatment of renal artery stenosis (RAS)?

What is the efficacy of surgical revascularization for renal artery stenosis (RAS)?

What is the role of bypass procedures in the treatment of renal artery stenosis (RAS)?

Which features predict successful restoration of renal function after revascularization in renal artery stenosis (RAS)?

What is the efficacy of angioplasty in the treatment of renal artery stenosis (RAS)?

What are the outcomes of angioplasty and surgical bypass for the treatment of renal artery stenosis (RAS)?

How does angioplasty compare to percutaneous revascularization for the treatments for renal artery stenosis (RAS)?

What are the benefits of angioplasty for the management of hypertension in renal artery stenosis (RAS)?

What is the efficacy of percutaneous transluminal angioplasty with stent (PTAS) for the treatment of renal artery stenosis (RAS)?

What is the best approach to treatment of atherosclerotic renal artery stenosis (RAS)?

What are the benefits of the addition of stenting to medical therapy for renal artery stenosis?

What is the evidence for the use of revascularization in the treatment of renal artery stenosis?

What are risk factors for mortality in the treatment of renal artery stenosis (RAS)?

What is the role of renal artery stenting in the treatment of renal artery stenosis (RAS)?

When is surgery indicated as first-line treatment for renal artery stenosis (RAS)?

What are the complication rates associated with percutaneous transluminal angioplasty with stent (PTAS) for the treatment of renal artery stenosis (RAS)?

What is the treatment of choice for renal artery fibromuscular dysplasia?

Which specialist consultations are beneficial in the treatment of renal artery stenosis (RAS)?

Guidelines

What are the treatment guidelines for renal artery fibromuscular dysplasia?

Which organizations have released treatment guidelines for renal artery stenosis (RAS)?

What are guidelines for the workup of renal artery stenosis (RAS)?

What are the class I recommendations for establishing a diagnosis of renal artery stenosis (RAS)?

What are the SCAI guidelines for use of renal angiography in renal artery stenosis (RAS)?

What are guidelines for first-line treatments of renal artery stenosis (RAS)?

What are ACC/AHA guidelines for percutaneous revascularization in renal artery stenosis (RAS)?

What are the treatment guidelines for ostial atherosclerotic renal artery stenosis (RAS)?

According to SCAI guidelines, which patients with renal artery stenosis (RAS) are most likely to benefit from renal artery stenting?

What are the ACC/AHA guidelines for surgical revascularization for renal artery stenosis (RAS)?

Medications

Which medications are used for the treatment of renal artery stenosis (RAS)?

Which medications in the drug class HMG-CoA reductase inhibitors are used in the treatment of Renal Artery Stenosis?

Which medications in the drug class Angiotensin II receptor antagonists are used in the treatment of Renal Artery Stenosis?

Which medications in the drug class Angiotensin-converting enzyme inhibitors are used in the treatment of Renal Artery Stenosis?

Follow-up

What is included in long-term monitoring of patients with renal artery stenosis (RAS)?

What is the prognosis of renal artery stenosis (RAS)?