11 research outputs found
Laparoscopic repositioning of a continuous ambulatory peritoneal dialysis (CAPD) catheter
Primary endoluminal stenting of transplant renal artery stenosis from cadaver and non-heart-beating donor kidneys
Differential modulation of mitogenic and metabolic actions of insulin-like growth factor I in rat glomerular mesangial cells in high glucose culture
Mechanisms of glucose-induced extracellular matrix overproduction by cultured vascular cells
Regulatory role of eicosanoids in extracellular matrix overproduction induced by long-term exposure to high glucose in cultured rat mesangial cells
Interventional Radiologic Techniques for Screening, Diagnosis and Treatment of Patients with Renal Artery Stenosis
Diagnosis and management of atherosclerotic renal artery stenosis: Improving patient selection and outcomes
Renal artery stenosis (RAS) is common among patients with atherosclerosis, and is found in 20–30% of individuals who undergo diagnostic cardiac catheterization. Renal artery duplex ultrasonography is the diagnostic procedure of choice for screening outpatients for RAS. Percutaneous renal artery stent placement is the preferred method of revascularization for hemodynamically significant RAS, and is favored over balloon angioplasty alone. Stent placement carries a class I recommendation for atherosclerotic RAS according to ACC and AHA guidelines. Discordance exists between the very high (>95%) procedural success rate and the moderate (60–70%) clinical response rate after renal stent placement, which is likely to be a result of poor selection of patients, inadequate angiographic assessment of lesion severity, and the presence of renal parencyhmal disease. Physiologic lesion assessment using translesional pressure gradients, and measurements of biomarkers (e.g. brain natriuretic peptide), or both, could enhance the selection of patients and improve clinical response rates. Long-term patency rates for renal stenting are excellent, with 5-year secondary patency rates greater than 90%. This Review will outline the clinical problem of atherosclerotic RAS and its diagnosis, and will critically assess treatment options and strategies to improve patients' outcomes