Renal Vascular Disease Flashcards
What is renal vascular disease?
An umbrella term used to describe causes of hypoperfusion in the kidneys
What do the vast majority of cases of renovascular disease occur secondary to?
Atherosclerotic disease
What % of cases of renal vascular disease occur secondary to atherosclerosis?
About 80%
What are the other causes of renal vascular disease?
- Renal vein thrombosis
- Fibromuscular dysplasia
- Embolism
- Post-transplant renal artery stenosis
How might renovascular disease present?
- Hypertension
- Decrease in renal function
- Recurrent pulmonary oedema in absence of systolic impairment
Describe the hypertension in renovascular disease?
Secondary hypertension, often resistant to medical therapy
What causes hypertension in renovascular disease?
RAAS activation
What might cause decrease in renal function with renovascular disease?
Risk factors or ACEi/ARB treatment
What is the gold standard investigation in renovascular disease?
Angiography
How might fibromuscular dysplasia present in renovascular disease?
‘Beads on a string’ appearance
What is the role of renal ultrasound in renovascular disease?
Cannot confirm the diagnosis, but may show asymmetrical kidneys
What does treatment of renovascular disease involve?
- Optimising risk factors
- Avoiding nephrotoxic agents
- Managing hypertension
When should angioplasty be offered in renovascular disease?
- Flash pulmonary oedema
- Hypertension refractory to medical therapy
What is haemolytic-uraemic syndrome (HUS)?
A microvascular renal disorder characterised by thrombotic angiopathy resulting in endothelial dysfunction
Who does HUS affect?
Primarily children
