[Natural history of renal artery stenosis]

The time delay necessary for the appearance of an atherosclerotic renal artery stenosis from the initial process of atherogenesis is not well known and is probably influenced by genetic factors and the classical risk factors (i.e. cholesterol, blood pressure levels...). The pathophysiology of fibromuscular dysplasic renal artery stenoses is even less known. Whatever the cause of a renal artery stenosis, blood pressure increases when the stenosis increases and becomes "significant" with a parallelism between the degree of the stenosis and the severity of hypertension. Renal artery stenoses can progress with time and lead to a complete occlusion of the involved renal artery. The progressive obstruction of the renal artery can lead to malignant hypertension and can also induce a gradual irreversible ischaemic renal damage leading to end-stage renal failure.