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Ischaemic nephropathy 

Ischaemic nephropathy
Chapter:
Ischaemic nephropathy
Author(s):

Helen Alderson

, Constantina Chrysochou

, James Ritchie

, and Philip A. Kalra

DOI:
10.1093/med/9780199592548.003.0212

May 24, 2018: This chapter has been re-evaluated and remains up-to-date. No changes have been necessary.

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date: 17 April 2021

Ischaemic nephropathy describes loss of renal function or renal parenchyma due to stenosis or occlusion of the renal artery or its branches. In the Western world, this is usually the result of atherosclerotic renovascular disease, but other aetiologies include arteritis, embolic disease, dissection, and fibromuscular disease.

Chronic kidney disease is the most common manifestation of ischaemic nephropathy, but hypertension, flash pulmonary oedema, sensitivity to angiotensin blockade, and sensitivity of glomerular filtration rate to blood pressure reduction are all possible manifestations of occlusive diseases of the renal artery or its branches. Proteinuria may also occur.

This chapter describes these clinical features and the outcomes of ischaemic nephropathy. It goes on to discuss the haemodynamics and mechanisms and what we understand of the pathophysiology of the condition.

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