Renovascular disease causes

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Causes

• Atherosclerotic Renal Artery Stenosis (ARAS)
  • Atherosclerosis accounts for approximately 90% of the cases of RAS and is the predominant lesion detected in patients >50 years of age
  • The presence and number of diseased coronary arteries predicts the likelihood of ARAS
  • RAS resulting from atherosclerotic disease is common in (18% to 20%) individuals undergoing coronary angiography (1)
  • RAS resulting from atherosclerotic disease is even more common (35% to 50%) in individuals undergoing peripheral vascular angiography for occlusive disease of the aorta and legs (2)
• Fibromuscular dysplasia
  • Unknown etiology
  • Second most common cause of RAS
  • Affects middle-aged women
  • More common in first-degree relatives and in the presence of the ACE-I allele.
  • Renal artery involvement is seen in 60% of cases - frequently bilateral compromise.
  • Progressive renal stenosis is seen in 37% of cases and loss of renal mass in 63%
• Nephroangiosclerosis (HTN injury)
• Diabetic Nephropathy (small vessels)
• Renal thromboembolic disease
• Atheroembolic renal disease
• Aortorenal dissection
• Post renal transplant RAS
• Renal artery vasculitis
• Trauma
• Neurofibromatosis
• Thromboangiitis obliterans
• Scleroderma

References

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