Renal Artery Stenosis Flashcards
What is renal artery stenosis?
Renal artery stenosis (RAS) refers to the narrowing of the lumen of one or both renal arteries, resulting in reduced kidney perfusion
What is the most common cause of renal artery stenosis?
atherosclerosis
Takayasu’s arteritis
Fibromuscular dysplasia
Thromboembolic disease
Neurofibromatosis
What is the gold standard to diagnose renal artery stenosis?
CT/MR renal angiogram which will show a “string-of beads” appearance”
What are the risk factors of renal artery stenosis?
Older age
Hypertension
Diabetes
Smoking
Obesity
Hyperlipidaemia
What are the symptoms of rneal artery stenosis?
Sudden onset severe hypertension that is treatment resistant
Sudden onset pulmonary oedema (flash pulmonary oedema)
Abdominal bruit
What is Takayasu’s arteritis?
Inflammation of the large and medium arteries involving the aorta and renal arteries causing stenosis
What is the medical management of renal artery stenosis?
Antihypertensives
ACE inhibitor and ARBs
What is the first line vascular intervention?
Angioplasty and stenting, which is indicated for refractory hypertension, flash pulmonary oedema and fibromuscular dysplasia
What accounts for around 90% of renal vascular disease?
Renal artery stenosis secondary to atherosclerosis
What is the most common cause of the remaining 10% of renal vascular disease?
Fibromuscular dysplasia
What percentage of patients with renal vascular disease are female?
90%
List three features of renal artery stenosis.
- Hypertension
- Chronic kidney disease or more acute renal failure (e.g. secondary to ACE-inhibitor initiation)
- ‘Flash’ pulmonary oedema
True or False: Chronic kidney disease is a feature of renal artery stenosis.
True
Fill in the blank: _______ is a feature associated with the initiation of ACE-inhibitors in renal artery stenosis.
Acute renal failure
What condition is characterized by ‘flash’ pulmonary oedema?
Renal artery stenosis
What accounts for around 90% of renal vascular disease?
Renal artery stenosis secondary to atherosclerosis
What is the most common cause of the remaining 10% of renal vascular disease?
Fibromuscular dysplasia
What percentage of patients with renal vascular disease are female?
90%
List three features of renal artery stenosis.
- Hypertension
- Chronic kidney disease or more acute renal failure (e.g. secondary to ACE-inhibitor initiation)
- ‘Flash’ pulmonary oedema
True or False: Chronic kidney disease is a feature of renal artery stenosis.
True
Fill in the blank: _______ is a feature associated with the initiation of ACE-inhibitors in renal artery stenosis.
Acute renal failure
What condition is characterized by ‘flash’ pulmonary oedema?
Renal artery stenosis
