Skip to main content

Renovascular Disease in the Elderly

  • Living reference work entry
  • First Online:
  • 118 Accesses

Abstract

Renovascular diseases (RVDs) that cause end-stage renal disease (ESRD) are inflammatory vasculitis, nephrosclerosis, RVD atheromatous and embolic disease. Renal artery stenosis is the cause of renovascular hypertension in at least 90%. Atherosclerosis involves 80% of the ostium and the proximal one-third of the renal artery. Renovascular hypertension and ischaemic nephropathy are most commonly seen in patients with atherosclerotic renal artery stenosis. Surgical procedures include PTRA and PTRAS (percutaneous renal artery angioplasty and stenting). This review summarises and provides an update in the management of renovascular disease.

This is a preview of subscription content, log in via an institution.

References

  1. ACC/AHA Pocket Guideline-Management of patients with peripheral arterial diseases. March 2006.

    Google Scholar 

  2. Eardley KS, Lipkin GW. Atherosclerotic renal artery stenosis: is it worth diagnosing? J Hum Hypertens. 1999;13(4):217–20.

    Article  CAS  PubMed  Google Scholar 

  3. Bosmans JL, De Broe ME. Renovascular hypertension: diagnostic and therapeutic challenges. JBR-BTR. 2004;87(1):32–5.

    CAS  PubMed  Google Scholar 

  4. Olin JW, Melia M, Young JR, Graor RA, Risius B. Prevalence of atherosclerotic renal artery stenosis in patients with atherosclerosis elsewhere. Am J Med. 1990;88:46N–51N.

    Article  CAS  PubMed  Google Scholar 

  5. Sawicki PT, Kaiser S, Heinemann L, Frenzel H, Berger M. Prevalence of renal artery stenosis in diabetes mellitus-an autopsy study. J Intern Med. 1991;229:489–4.

    Article  CAS  PubMed  Google Scholar 

  6. Zierler RE, Bergelin RO, Polissar NL, Beach KW, Caps MT, Cantwell-Gab K, et al. Carotid and lower extremity arterial disease in patients with renal artery atherosclerosis. Arch Intern Med. 1998;158:761–767.

    Article  CAS  PubMed  Google Scholar 

  7. Zoccali C, Mallamaci F, Finocchiaro P. Atherosclerotic renal artery stenosis: Epidemiology, cardiovascular outcomes and clinical prediction rules. JASN. 2002;1:S179–S183.

    Article  Google Scholar 

  8. Pickering TG, Herman L, Devereux RB, Sotelo JE, James GD, Sos TA, et al. Recurring pulmonary oedema in synchronous due to bilateral renal artery stenosis: treatment by angioplasty or surgical revascularisation. Lancet. 1988;2:551–552.

    Article  CAS  PubMed  Google Scholar 

  9. Walker F, Walker DA, Neilson M. Flash pulmonary oedema. Lancet. 2001; 358:556

    Article  CAS  PubMed  Google Scholar 

  10. Woolfson RG. Renal failure in atherosclerotic renovascular disease: pathogenesis, diagnosis and intervention. Postgrad Med J. 2001;77:68–74.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  11. Woolfson RG, Neild GH. The true clinical significance of renography in nephron-urology. Eur J Nucl Med. 1997;24:557–570.

    CAS  PubMed  Google Scholar 

  12. Dawson DL. Non-invasive assessment of renal artery stenosis. Sem Vasc Surg 1996;9:172–181.

    CAS  Google Scholar 

  13. Krijen P, van Jaarsveld BC, Steyerberg EW, Man in’t Veld AJ, Schalekamp MA, Habbema JD. A clinical prediction rule for renal artery stenosis. Ann Intern Med. 1998;129:705–711.

    Article  Google Scholar 

  14. Klahr S. Role of dietary protein and blood pressure in the progression of renal disease. Kidney Int. 1990;49:1783–1786.

    Article  Google Scholar 

  15. UK Prospective Diabetes Study Group. Tight blood pressure control and risk of macrovascular and microvascular complications in type 2 diabetes UKPDS 38, BMJ. 1998;317:934–939..

    Article  Google Scholar 

  16. Girotra S, Murarka S, Migrino RQ. Plaque regression and improved clinical outcomes following statin treatment in atherosclerosis. Panminerva Med. 2012;54(2):71–81.

    CAS  PubMed  Google Scholar 

  17. United States Renal Data System 1997. Annual Data Report. Am J Kidney Dis. 1997;30(Suppl1).

    Google Scholar 

  18. Geddes CC, Jardine AG. Diagnosis and treatment of atherosclerotic renal artery disease (ARAS). Minerva Urol Nefrol. 2002;54(1): 29–36.

    CAS  PubMed  Google Scholar 

  19. Zahringer M, Sapoval M, Pattynama PM, Rabbia C, Vignali C, Maleux G, et al. Sirolimus-eluting versus bare-metal profile stent for renal artery treatment (GREAT Trial), angiographic follow up after 6 months and clinical outcome up to 2 years. J Endovasc Ther. 2007;14:460–468.

    Article  PubMed  Google Scholar 

  20. Cooper CJ. Embolic protection and platelet inhibition during renal artery stenting. Circulation. 2008;117:2752–2760.

    Article  CAS  PubMed  Google Scholar 

  21. Anand S, Johansen KL, Tamura MK. Aging and chronic kidney disease: the impact on physical function and cognition. J Gerontol A Biol Sci Med Sci. 2014;69A(3):315–322. https://doi.org/10.1093/Gerona/glt109.

    Article  Google Scholar 

  22. Zalai D, Szeifert L, Novsak M. Psychological distress and depression in patients with chronic kidney disease. Semin Dial. 2012;25(4):428–38.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Nages Nagaratnam .

Rights and permissions

Reprints and permissions

Copyright information

© 2017 Springer International Publishing AG

About this entry

Cite this entry

Nagaratnam, N., Nagaratnam, K., Cheuk, G. (2017). Renovascular Disease in the Elderly. In: Geriatric Diseases. Springer, Cham. https://doi.org/10.1007/978-3-319-32700-6_35-1

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-32700-6_35-1

  • Received:

  • Accepted:

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-32700-6

  • Online ISBN: 978-3-319-32700-6

  • eBook Packages: Springer Reference MedicineReference Module Medicine

Publish with us

Policies and ethics