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Atherosclerotic ischemic renal disease

B A Greco1, J A Breyer

  • 1Division of Nephrology, Vanderbilt University Medical Center, Nashville, TN 37205, USA.

American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation
|February 1, 1997
PubMed
Summary

Ischemic nephropathy, often caused by renal artery stenosis, is increasingly recognized as treatable. Advances in screening and interventions like angioplasty improve kidney function outcomes.

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Area of Science:

  • Nephrology
  • Cardiovascular Medicine
  • Vascular Surgery

Background:

  • Ischemic nephropathy is a recognized clinical entity, primarily caused by atherosclerotic renal artery stenosis.
  • This condition is prevalent in aging populations undergoing renal replacement therapy, often with co-existing systemic atherosclerosis and comorbidities.
  • Patients increasingly present with advanced disease, diffuse atherosclerosis, and multiple health issues.

Purpose of the Study:

  • To review the evolving understanding and management of ischemic nephropathy.
  • To highlight advancements in screening, patient selection, and interventional strategies.
  • To discuss the pathophysiologic basis of acute and chronic renal ischemia.

Main Methods:

  • Review of recent literature on ischemic nephropathy and renal artery stenosis.
  • Analysis of outcomes associated with improved screening and interventional approaches.
  • Synthesis of pathophysiologic concepts from acute ischemia studies to chronic conditions.

Main Results:

  • Improved screening and interventional techniques have led to better outcomes in managing ischemic renal disease.
  • Percutaneous transluminal renal angioplasty is a preferred treatment for nonostial renal artery stenosis in some centers.
  • Both angioplasty and surgical repair demonstrate benefits for preserving renal function.

Conclusions:

  • Ischemic nephropathy is a treatable condition requiring timely diagnosis and intervention.
  • Advances in interventional cardiology and surgery offer effective options for renal function salvage.
  • Understanding the transition from acute to chronic renal ischemia is crucial for effective management.

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