An Update on Renovascular Hypertension

Overview

Journal Curr Cardiol Rep

Publisher Current Science

Specialty Cardiology & Vascular Diseases

Date 2005 Nov 1

PMID 16256008

Citations 6

Authors

Martin Senitko

Andrew Z Fenves

Affiliations

Soon will be listed here.

Abstract

Renovascular hypertension (RVH) represents a secondary and potentially remediable form of hypertension. Elevated blood pressure is only one of a broad array of pathophysiologic consequences that are associated with decreased renal perfusion. Our ability to accurately and noninvasively detect stenotic lesions within the renal artery is growing. However, functional assessment of renal parenchyma and hemodynamic significance of renal artery lesions is still limited. Advances in endovascular techniques spurred interest in the concept of ischemic nephropathy and the effect of renal artery revascularization on renal function. Despite the relative frequency of atherosclerotic renal artery stenosis (ARAS), there currently is no consensus on the most appropriate therapy. In this article, we focus on the two most common causes of RVH, ARAS and fibromuscular dysplasia. We discuss the therapeutic strategies, disease mechanisms, clinical findings, evolving trends, and developments.

Citing Articles

Magnetic Resonance Imaging in Atherosclerotic Renal Artery Stenosis: The Update and Future Directions from Interventional Perspective.

Fu J, Lin Z, Zhang B, Song L, Qin N, Qiu J Kidney Dis (Basel). 2024; 10(1):23-31.

PMID: 38322626 PMC: 10843188. DOI: 10.1159/000534499.

Flower Extract Alters Gut Microbiota and Fecal Metabolomic Profiles of 2K1C Hypertensive Rats.

Sornchuer P, Thongsepee N, Wongsaroj L, Saninjuk K, Wattanaphansak S, Pongpamorn P Nutrients. 2023; 15(2).

PMID: 36678139 PMC: 9862316. DOI: 10.3390/nu15020268.

An Outline of Renal Artery Stenosis Pathophysiology-A Narrative Review.

Dobrek L Life (Basel). 2021; 11(3).

PMID: 33799957 PMC: 8000991. DOI: 10.3390/life11030208.

Alteration of the Gut Microbiota and Its Effect on AMPK/NADPH Oxidase Signaling Pathway in 2K1C Rats.

Yu H, Qin L, Hu H, Wang Z Biomed Res Int. 2019; 2019:8250619.

PMID: 31240226 PMC: 6556358. DOI: 10.1155/2019/8250619.

A Unique Case of Renovascular Hypertension due to Fibromuscular Dysplasia in an Extra-renal Artery.

Sakuma I, Saito J, Matsuzawa Y, Omura M, Matsui S, Nishikawa T Intern Med. 2018; 57(18):2689-2694.

PMID: 29709926 PMC: 6191605. DOI: 10.2169/internalmedicine.0023-17.

References

Postma C, van der Steen P, Hoefnagels W, de Boo T, Thien T . The captopril test in the detection of renovascular disease in hypertensive patients. Arch Intern Med. 1990; 150(3):625-8. View

Gavras H, Brunner H, Thurston H, LARAGH J . Reciprocation of renin dependency with sodium volume dependency in renal hypertension. Science. 1975; 188(4195):1316-7. DOI: 10.1126/science.1145199. View

GIFFORD Jr R, McCORMACK L, Poutasse E . The atrophic kidney: its role in hypertension. Mayo Clin Proc. 1965; 40(11):834-52. View

Brown J, Davies D, Morton J, Robertson J, Cuesta V, Lever A . Mechanism of renal hypertension. Lancet. 1976; 1(7971):1219-21. DOI: 10.1016/s0140-6736(76)92165-6. View

EPSTEIN F . Oxygen and renal metabolism. Kidney Int. 1997; 51(2):381-5. DOI: 10.1038/ki.1997.50. View

Harding M, Smith L, Himmelstein S, Harrison K, Phillips H, Schwab S . Renal artery stenosis: prevalence and associated risk factors in patients undergoing routine cardiac catheterization. J Am Soc Nephrol. 1992; 2(11):1608-16. DOI: 10.1681/ASN.V2111608. View

de Haan M, Kroon A, Flobbe K, Kessels A, Tordoir J, van Engelshoven J . Renovascular disease in patients with hypertension: detection with duplex ultrasound. J Hum Hypertens. 2002; 16(7):501-7. DOI: 10.1038/sj.jhh.1001429. View

Textor S . Ischemic nephropathy: where are we now?. J Am Soc Nephrol. 2004; 15(8):1974-82. DOI: 10.1097/01.ASN.0000133699.97353.24. View

Libertino J, Bosco P, YING C, Breslin D, Woods B, Tsapatsaris N . Renal revascularization to preserve and restore renal function. J Urol. 1992; 147(6):1485-7. DOI: 10.1016/s0022-5347(17)37603-6. View

10.

Goncharenko V, Gerlock Jr A, Shaff M, Hollifield J . Progression of renal artery fibromuscular dysplasia in 42 patients as seen on angiography. Radiology. 1981; 139(1):45-51. DOI: 10.1148/radiology.139.1.7208940. View

11.

Higashi Y, Sasaki S, Nakagawa K, Matsuura H, Oshima T, Chayama K . Endothelial function and oxidative stress in renovascular hypertension. N Engl J Med. 2002; 346(25):1954-62. DOI: 10.1056/NEJMoa013591. View

12.

Zeller T, Frank U, Muller C, Burgelin K, Sinn L, Horn B . Stent-supported angioplasty of severe atherosclerotic renal artery stenosis preserves renal function and improves blood pressure control: long-term results from a prospective registry of 456 lesions. J Endovasc Ther. 2004; 11(2):95-106. DOI: 10.1583/03-1062.1. View

13.

Bolduc J, Oliva V, Therasse E, Giroux M, Bouchard L, Perreault P . Diagnosis and treatment of renovascular hypertension: a cost-benefit analysis. AJR Am J Roentgenol. 2005; 184(3):931-7. DOI: 10.2214/ajr.184.3.01840931. View

14.

Berglund G, Andersson O, Wilhelmsen L . Prevalence of primary and secondary hypertension: studies in a random population sample. Br Med J. 1976; 2(6035):554-6. PMC: 1688084. DOI: 10.1136/bmj.2.6035.554. View

15.

Taylor A . Renovascular hypertension: nuclear medicine techniques. Q J Nucl Med. 2002; 46(4):268-82. View

16.

Textor S, Novick A, Mujais S, Ross R, Bravo E, Fouad F . Responses of the stenosed and contralateral kidneys to [Sar1, Thr8] AII in human renovascular hypertension. Hypertension. 1983; 5(5):796-804. DOI: 10.1161/01.hyp.5.5.796. View

17.

Krijnen P, van Jaarsveld B, Steyerberg E, Man in t Veld A, SCHALEKAMP M, Habbema J . A clinical prediction rule for renal artery stenosis. Ann Intern Med. 1998; 129(9):705-11. DOI: 10.7326/0003-4819-129-9-199811010-00005. View

18.

Inagami T, Mizuno K, Kawamura M, Okamura T, Clemens D, Higashimori K . Localization of components of the renin-angiotensin system within the kidney and sustained release of angiotensins from isolated and perfused kidney. Tohoku J Exp Med. 1992; 166(1):17-26. DOI: 10.1620/tjem.166.17. View

19.

Airoldi F, Palatresi S, Marana I, Bencini C, Benti R, Lovaria A . Angioplasty of atherosclerotic and fibromuscular renal artery stenosis: time course and predicting factors of the effects on renal function. Am J Hypertens. 2000; 13(11):1210-7. DOI: 10.1016/s0895-7061(00)01206-1. View

20.

Anderson Jr G, Blakeman N, Streeten D . The effect of age on prevalence of secondary forms of hypertension in 4429 consecutively referred patients. J Hypertens. 1994; 12(5):609-15. DOI: 10.1097/00004872-199405000-00015. View