Interní Med. 2009; 11(6): 267-271

Renovascular disease - clinical manifestation, diagnosis, therapy

prof. MUDr. Jan Peregrin, CSc¹, MUDr. Marcela Bürgelová, Ph.D²

¹ Základna radiodiagnostiky a intervenční radiologie, IKEM, Praha

² Klinika nefrologie TC IKEM a Subkatedra nefrologie IPVZ

Renovascular disease presents clinically by two main symptoms – renovascular hypertension and ischemic nephropathy. It is caused by

renal artery/arteries stenosis (RAS), mainly due to atherosclerosis. Less frequent cause of RAS is fibromuscular dysplasia (it affects mainly

younger females), rarely arteritis, neurofibromatosis or other diseases.

Renovascular hypertension is the determinant of approximately 1–5 % of all hypertensions, but there is no positive proof, that in all patients

with RAS, the stenosis is the cause of hypertension. The therapy is either conservative (medical treatment together with lifestyle

modifications) or invasive, nowadays mainly renal angioplasty (PTRA), the non-atheromatous lesions having better chance for positive

clinical outcome.

Ischemic nephropathy can finally cause complete loss of kidney function. Successful PTRA can either improve (failing) kidney function,

or at least stabilize the progression of kidney function impairment in about 30–60 % of the cases.

Special groups of patients (children, transplanted kidney recipients) are discussed together with PTRA technique and complications.

Keywords: renovascular disease, renovascular hypertension, ischemic nephropathy, renal angioplasty.

Published: July 1, 2009  Show citation