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Renovascular disease 

Renovascular disease
Chapter:
Renovascular disease
Author(s):

B. Rigden Green

and M. G. Wyatt

DOI:
10.1093/med/9780199658220.003.0064
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date: 17 September 2019

Renovascular disease is a recognized cause of secondary hypertension. The two main causes of renal artery stenosis are atherosclerosis and fibromuscular dysplasia. Treatment of renovascular disease can result in improved blood pressure control and reduction in progression of renal failure. All patients with renovascular disease should be managed with risk factor modification and best medical treatment in the first instance. Subsequent therapeutic strategies include surgical and endovascular techniques, with the preferred modality being endovascular. These treatments should only be carried out in patients who have failed medical management and when hypertension or ischaemic nephropathy is due to renal artery stenosis. It should be noted that not all patients with hypertension have a renovascular cause and not all patients with renovascular disease require treatment. Thus careful patient selection is essential to reduce unnecessarily exposing patients to the periprocedural risks involved in invasive treatment.

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