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The management of renovascular disease: ASTRAL and beyond

Ching M Cheung1, Constantina Chrysochou, Philip A Kalra

  • 1Renal Department, Salford Royal Hospital, Stott Lane, Salford, Greater Manchester, UK.

Current Opinion in Nephrology and Hypertension
|November 4, 2010
PubMed

Insights

Optimal medical management is key for atheromatous renovascular disease (ARVD). Revascularization benefits are unclear, and future research should identify suitable candidates for this treatment.

Area of Science:

  • Nephrology
  • Cardiovascular Medicine
  • Vascular Surgery

Background:

  • Atheromatous renovascular disease (ARVD) affects kidney function due to arterial narrowing.
  • Recent advances in understanding ARVD pathophysiology and epidemiology have emerged.

Purpose of the Study:

  • To review new findings in atheromatous renovascular disease (ARVD) literature since 2009.
  • To analyze the impact of recent randomized controlled trials on ARVD management.

Main Methods:

  • Literature review of ARVD studies published from 2009 onwards.
  • Analysis of data from two major randomized controlled trials.

Main Results:

  • Epidemiological data on ARVD has been updated.
  • Randomized controlled trials show limited benefits of revascularization.
  • Improved understanding of ischemic kidney pathophysiology.
  • Advances in imaging for selecting patients for revascularization.

Conclusions:

  • Optimal medical management is the primary treatment for ARVD.
  • Renal revascularization is not the cornerstone of ARVD therapy.
  • Further research is needed to identify patients who will benefit from revascularization.
Abstract

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