Revascularization may accelerate renal dysfunction in hypertensive patients with moderate atherosclerotic stenosis of renal arteries

Abstract

Atherosclerotic renal artery stenosis (ARAS) accounts for more than 90% of cases with renal artery stenosis, which is the recognized cause of secondary hypertension, renal dysfunction and acute pulmonary edema. It is estimated that about 15% of patients with hypertension also have different degrees of ARAS at the same time. Hypertension is known to be associated with the risk of atherosclerotic vascular disease; these two conditions usually co-exist and interact with each other. At present, many studies have focused on how to intervene ARAS correctly or just optimal medical therapy (OMT). For patients with severe ARAS, stent implantation seems to be able to receive better clinical benefits because it can avoid renal ischemic injury; however, it remains inconclusive whether stent implantation is suitable for the essential hypertension patients accompanied with mild to moderate ARAS. We speculate that renal artery revascularization may accelerate renal dysfunction in essential hypertensive patients accompanied with mild to moderate ARAS, especially when hypertension could not be controlled within the normal range after the revascularization.