Renal Arterial Disease and Hypertension

Med Clin North Am. 2017 Jan;101(1):65-79. doi: 10.1016/j.mcna.2016.08.010.


Renal artery disease produces a spectrum of progressive clinical manifestations ranging from minor degrees of hypertension to circulatory congestion and kidney failure. Moderate reductions in renal blood flow do not induce tissue hypoxia or damage, making medical therapy for renovascular hypertension feasible. Several prospective trials indicate that optimized medical therapy using agents that block the renin-angiotensin system should be the initial management. Evidence of progressive disease and/or treatment failure should allow recognition of high-risk subsets that benefit from renal revascularization. Severe reductions in kidney blood flow ultimately activate inflammatory pathways that do not reverse with restoring blood flow alone.

Keywords: Angiotensin; Hypertension; Ischemic nephropathy; Kidney; Renal artery stenosis; Renovascular.

Publication types

  • Review

MeSH terms

  • Angioplasty
  • Antihypertensive Agents / therapeutic use
  • Humans
  • Hypertension / diagnosis*
  • Hypertension / etiology
  • Hypertension / therapy*
  • Renal Artery Obstruction / diagnosis*
  • Renal Artery Obstruction / epidemiology
  • Renal Artery Obstruction / physiopathology
  • Renal Artery Obstruction / therapy*
  • Renin-Angiotensin System
  • Stents


  • Antihypertensive Agents