Renal artery stenosis
Description
- Narrowing of a renal artery -> dec perfusion -> renin release -> renovascular hypertension, and if severe or bilateral, ischaemic nephropathy
Two diseases with the same name
| Atherosclerotic (~90%) | Fibromuscular dysplasia (~10%) | |
|---|---|---|
| Who | Older, smokers, diffuse vascular disease | Young women (15-50) |
| Site | Ostial and proximal third | Mid-to-distal artery, often bilateral |
| Angiogram | Focal or eccentric stenosis + aortic plaque | *'String of beads'* - alternating stenosis and aneurysmal dilatation |
| Kidney | Progressive atrophy | Often a small ipsilateral kidney |
| Treatment | Medical - revascularisation rarely helps | Angioplasty, usually curative |
| Course | Progressive, part of systemic atherosclerosis | Non-atherosclerotic, non-inflammatory |
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