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- Title
How important is atheromatous renal artery stenosis as a cause of end-stage renal disease?
- Authors
Main, John; Main, J
- Abstract
In recent years atheromatous renal artery stenosis has been proposed as a common and potentially preventable cause of end-stage renal disease (ESRD). Occlusive renal artery disease causes renal failure that can be reversed following successful revascularization, but this scenario is relatively rare. Nonocclusive renal artery stenosis is commonly found in association with varying degrees of renal impairment. However, recent evidence and clinical observation suggest that a cause and effect relationship is unlikely. Experimentally, split renal function studies in cases of unilateral stenosis find similar degrees of renal impairment in both kidneys. Clinically, severe renal impairment is often found in the presence of unilateral stenoses. Another nephropathic process must be going on, probably a combination of hypertensive and atheroembolic damage. It is not surprising that the two pathologies often coexist, in view of their shared causes (principally hypertension and tobacco smoking). Previous studies of the importance of renal artery stenosis in causing ESRD probably included many cases of hypertensive and atheroembolic nephropathy. Unfortunately the potential for renal revascularization to prevent ESRD has been exaggerated.
- Subjects
CHRONIC kidney failure; ARTERIAL stenosis
- Publication
Seminars in Dialysis, 2001, Vol 14, Issue 3, p143
- ISSN
0894-0959
- Publication type
editorial
- DOI
10.1046/j.1525-139X.2001.00039.x