Renal artery stenosis classification

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Overview

Classification of ARAS may be according to anatomical severity of the lesion or may be by hemodynamic significance.

Classification

Renal artery stenosis may be classified according to whether there is unilateral or bilateral involvement of the renal arteries. Additionally, renal artery stenosis is often classified anatomically according to severity of luminal narrowing. The following criteria are used according to most published studies about ARAS.[1][2]

Severity Luminal Narrowing
Normal 0%
Mild 1-49%
Moderate 50-69%
Severe 70-99%
Occluded 100%

To note, some studies have different classification criteria than those listed above, with "mild disease" starting after 50% of luminal narrowing. Such classification remains coherent with the definition of ARAS as narrowing > 50%.[3]

Another classification is based on hemodynamic function in RAS. This classification simply differentiates between hemodynamically insignificant RAS (< 75% stenosis) and hemodynamically significant RAS (> 75% stenosis).[4]

References

  1. Kliewer MA, Tupler RH, Carroll BA, Paine SS, Kriegshauser JS, Hertzberg BS; et al. (1993). "Renal artery stenosis: analysis of Doppler waveform parameters and tardus-parvus pattern". Radiology. 189 (3): 779–87. doi:10.1148/radiology.189.3.8234704. PMID 8234704.
  2. Desberg AL, Paushter DM, Lammert GK, Hale JC, Troy RB, Novick AC; et al. (1990). "Renal artery stenosis: evaluation with color Doppler flow imaging". Radiology. 177 (3): 749–53. doi:10.1148/radiology.177.3.2243982. PMID 2243982.
  3. Lao D, Parasher PS, Cho KC, Yeghiazarians Y (2011). "Atherosclerotic renal artery stenosis--diagnosis and treatment". Mayo Clin Proc. 86 (7): 649–57. doi:10.4065/mcp.2011.0181. PMC 3127560. PMID 21719621.
  4. 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.