Evaluation of Renal Artery Stenosis in Dialysis Patients

Atherosclerotic renal artery stenosis (RAS), recognized as a contributor to chronic kidney disease (CKD), may be present in a substantial fraction of dialysis patients. It is generally unknown what proportion of end‐stage renal disease patients on dialysis could recover kidney function if RAS were t...

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Bibliographic Details
Published in:Seminars in dialysis 2009-09, Vol.22 (5), p.519-523
Main Authors: Dwyer, Jamie P., Greco, Barbara A., Lewis, Julia B.
Format: Article
Language:English
Subjects:
Chronic Disease
Humans
Kidney Diseases - etiology
Kidney Diseases - therapy
Renal Artery Obstruction - complications
Renal Artery Obstruction - diagnosis
Renal Artery Obstruction - therapy
Renal Dialysis
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Summary:Atherosclerotic renal artery stenosis (RAS), recognized as a contributor to chronic kidney disease (CKD), may be present in a substantial fraction of dialysis patients. It is generally unknown what proportion of end‐stage renal disease patients on dialysis could recover kidney function if RAS were treated. Patients with CKD are often inadequately screened for RAS because of technical limitations of various screening modalities. Multiple small case series and studies have evaluated the role of revascularization for renal salvage in dialysis patients with RAS; these studies are reviewed. Large prospective, randomized multicenter trials of intervention for RAS exclude patients with advanced CKD. The risks of intervention must be weighed against the potential for renal recovery, even when predictors of success are not known with certainty.
ISSN:0894-0959
1525-139X
DOI:10.1111/j.1525-139X.2009.00618.x