Renal artery stenosis history and symptoms: Difference between revisions
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==Overview== | ==Overview== | ||
Resistant hypertension and a decrease in estimated [[glomerular filtration rate]] (eGFR) in a patient known to have [[atherosclerosis]] are 3 elements that are very important to raise the suspicion of atherosclerotic renal artery stenosis. Other factors, such as [[hypertension]] at an early age or [[malignant hypertension]], play a major role as well. | Resistant [[hypertension]] and a decrease in estimated [[glomerular filtration rate]] (eGFR) in a patient known to have [[atherosclerosis]] are 3 elements that are very important to raise the suspicion of [[Atherosclerosis|atherosclerotic]] [[renal artery stenosis]]. Other factors, such as [[hypertension]] at an early age or [[malignant hypertension]], play a major role as well. | ||
==History and symptoms== | ==History and symptoms== | ||
According to the KDOQI Clinical Practice Guidelines on Hypertension and Antihypertensive Agents in Chronic Kidney Disease<ref name="pmid15114537">{{cite journal| author=Kidney Disease Outcomes Quality Initiative (K/DOQI)| title=K/DOQI clinical practice guidelines on hypertension and antihypertensive agents in chronic kidney disease. | journal=Am J Kidney Dis | year= 2004 | volume= 43 | issue= 5 Suppl 1 | pages= S1-290 | pmid=15114537 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15114537 }} </ref>, the most important clinical clues that should raise the suspicion of renal artery disease are the triad: | According to the KDOQI Clinical Practice Guidelines on Hypertension and [[Antihypertensive]] Agents in [[Chronic kidney diseas|Chronic Kidney Disease]]<ref name="pmid15114537">{{cite journal| author=Kidney Disease Outcomes Quality Initiative (K/DOQI)| title=K/DOQI clinical practice guidelines on hypertension and antihypertensive agents in chronic kidney disease. | journal=Am J Kidney Dis | year= 2004 | volume= 43 | issue= 5 Suppl 1 | pages= S1-290 | pmid=15114537 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15114537 }} </ref>, the most important clinical clues that should raise the suspicion of renal artery disease are the triad: | ||
* Resistant Hypertension | |||
| | * Reduced in estimated [[Glomerular filtration rate|glomerular filteration rate]] (eGFR) | ||
* Known generalized [[atherosclerosis]] | |||
Additional clinical clues that suggest renal artery disease are listed below<ref name="pmid15114537">{{cite journal| author=Kidney Disease Outcomes Quality Initiative (K/DOQI)| title=K/DOQI clinical practice guidelines on hypertension and antihypertensive agents in chronic kidney disease. | journal=Am J Kidney Dis | year= 2004 | volume= 43 | issue= 5 Suppl 1 | pages= S1-290 | pmid=15114537 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15114537 }} </ref>: | |||
*Age of [[hypertension]] < 30 years and > 55 years | *Age of [[hypertension]] < 30 years and > 55 years | ||
*Abrupt onset of [[hypertension]] | *Abrupt onset of [[hypertension]] | ||
| Line 33: | Line 25: | ||
*[[Flash pulmonary edema]] | *[[Flash pulmonary edema]] | ||
*Generalized atherosclerosis obliterans | *Generalized atherosclerosis obliterans | ||
*Asymmetric kidney sizes | *Asymmetric [[kidney]] sizes | ||
*[[Acute kidney injury]] when ACE-I or ARB are used for treatment | *[[Acute kidney injury]] when ACE-I or ARB are used for treatment | ||
Revision as of 23:33, 15 December 2020
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Yazan Daaboul, Serge Korjian
Overview
Resistant hypertension and a decrease in estimated glomerular filtration rate (eGFR) in a patient known to have atherosclerosis are 3 elements that are very important to raise the suspicion of atherosclerotic renal artery stenosis. Other factors, such as hypertension at an early age or malignant hypertension, play a major role as well.
History and symptoms
According to the KDOQI Clinical Practice Guidelines on Hypertension and Antihypertensive Agents in Chronic Kidney Disease[1], the most important clinical clues that should raise the suspicion of renal artery disease are the triad:
- Resistant Hypertension
- Reduced in estimated glomerular filteration rate (eGFR)
- Known generalized atherosclerosis
Additional clinical clues that suggest renal artery disease are listed below[1]:
- Age of hypertension < 30 years and > 55 years
- Abrupt onset of hypertension
- Accelerated hypertension that was previously well-controlled
- Refractory hypertension to 3 anti-hypertensive medications
- Malignant hypertension
- Smoking
- Abdominal bruit
- Flash pulmonary edema
- Generalized atherosclerosis obliterans
- Asymmetric kidney sizes
- Acute kidney injury when ACE-I or ARB are used for treatment
References
- ↑ 1.0 1.1 Kidney Disease Outcomes Quality Initiative (K/DOQI) (2004). "K/DOQI clinical practice guidelines on hypertension and antihypertensive agents in chronic kidney disease". Am J Kidney Dis. 43 (5 Suppl 1): S1–290. PMID 15114537.