Evaluation and treatment of renal artery stenosis: impact on blood pressure and renal function

The conventional non-invasive tests to diagnose renal artery stenosis in a general hypertensive population are not accurate enough for screening purpo ses. Magnetic resonance angiography might become the new gold standard, wit h the advantages of the absence of contrast toxicity, good accuracy, and in formation on flow characteristics. With regard to the treatment of hyperten sion in patients with renal artery stenosis, intervention is advised only w hen blood pressure cannot be controlled by at least three antihypertensive drugs. Patency after stenting is superior to angioplasty, although its clin ical benefit has not been proved. As for renal function, evidence - althoug h from uncontrolled studies - for the preservation of renal function by int ervention is accumulating, especially in those patients with bilateral sten osis or stenosis in a single functioning kidney. Curr Opin Nephrol Hyperten s 10:399-404, (C) 2001 Lippincoit Williams & Wilkins.