Renal artery stenosis causes
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Renal artery stenosis is most commonly caused by development of atherosclerotic plaque in the renal arteries (termed atherosclerotic renal artery stenosis). Less frequently, it is caused by fibromuscular dysplasia.
Causes
Renal artery stenosis commonly results from atherosclerosis or fibromuscular dysplasia.
Atherosclerotic Renal Artery Stenosis
In atherosclerotic RAS, patients typically present with a progressive worsening of preexisting hypertension, often with a modest increase in serum creatinine. It is featured by an accelerated rise in systolic blood pressure, accompanying target-organ damage, and decline of renal function during antihypertensive therapy. ARAS is sometimes heralded by crescendo angina, resistant congestive heart failure, or flash pulmonary edema.
Fibromuscular Dysplasia
Fibromuscular dysplasia commonly affects mid-portions of the renal artery in younger individuals and rarely leads to major loss of renal function, although some progression may be seen, particularly in smokers. Fibromuscular dysplasia lesions appear most often as hypertension of early-onset and unusual severity. Occasionally, it presents as hypertension during pregnancy.