Renal Artery Obstruction (Renal Artery Stenosis)

Narrowing or occlusion of the RENAL ARTERY or arteries. It is due usually to ATHEROSCLEROSIS; FIBROMUSCULAR DYSPLASIA; THROMBOSIS; EMBOLISM, or external pressure. The reduced renal perfusion can lead to renovascular hypertension (HYPERTENSION, RENOVASCULAR).

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Networked: 2125 relevant articles (125 outcomes, 252 trials/studies)

Relationship Network

Disease Context: Research Results

Related Diseases

1.	Hypertension (High Blood Pressure)
2.	Fibromuscular Dysplasia
3.	Pathologic Constriction (Stenosis)
4.	Renovascular Hypertension (Goldblatt Syndrome)
5.	Renal Hypertension

Experts

1.	Textor, Stephen C: 28 articles (08/2015 - 04/2008)
2.	Lerman, Lilach O: 26 articles (01/2016 - 03/2004)
3.	Zeller, Thomas: 18 articles (11/2014 - 07/2002)
4.	Lerman, Amir: 14 articles (01/2016 - 04/2004)
5.	Misra, Sanjay: 12 articles (08/2013 - 02/2003)
6.	Bürgelin, Karlheinz: 12 articles (09/2007 - 07/2002)
7.	Frank, Ulrich: 12 articles (09/2007 - 07/2002)
8.	Müller, Christian: 12 articles (08/2007 - 07/2002)
9.	Jaff, Michael R: 9 articles (12/2014 - 05/2005)
10.	White, Christopher J: 9 articles (12/2014 - 01/2005)

Drugs and Biologics

Drugs and Important Biological Agents (IBA) related to Renal Artery Obstruction:

1.	ReninIBA 10/01/1994 - "However, the poor specificity was related to certain clinical characteristics; high baseline plasma renin activity measurements, female gender, current smoking, renal dysfunction, and bilateral renal artery stenosis were all associated with false-positive results. " 11/01/1999 - "The aim of this study was to determine the role of renal innervation in the prolonged stimulation of renin secretion and renin synthesis accompanying renal artery stenosis. " 04/01/1990 - "The distribution of renin-containing cells in kidneys with renal artery stenosis--an immunocytochemical study." 04/01/1989 - "All had lateralizing renal venous renin ratio (RVRR) studies, 15 had renal artery stenosis (RAS) on angiography and one had unilateral chronic parenchymal renal disease (CPRD). " 12/01/1983 - "Levels of plasma renin activity were considerably higher in the renal artery stenosis patients and remained unchanged during the study; there was a progressive fall in levels in each of the patients with renal parenchymal disease. "
2.	Captopril (Capoten)FDA LinkGeneric 11/01/1985 - "Recent studies have reported that captopril can acutely induce a marked decrease of glomerular filtration rate in kidneys affected by renal artery stenosis, an effect detectable by scintigraphic techniques. " 06/01/2010 - "Captopril induced a significant reduction of the glomerular filtration rate in the group with renal artery stenosis (to 32.6+/-14.8 ml/ kg/1.73m(2), p=0.001) and an insignificant change in the group without RAS (to 62.2+/-23.6 ml/kg/1.73m(2), p=0.68). " 01/01/1994 - "Using the radiologic findings as the definitive test, the sensitivity and specificity of post-captopril RVR measurements in detecting unilateral or bilateral renal artery stenoses (85% or greater of lumen) was 61 and 96%, and 92 and 90%, respectively, a significant improvement compared with those of pre-captopril RVR measurements (44 and 62%, and 17 and 93%, respectively). " 11/01/2002 - "Captopril-enhanced renography and scintigraphy and the resistive index at Doppler sonography may be very useful in patients with renal artery stenosis for predicting the response to revascularization." 01/01/2004 - "The aim of the present study was correlation of 99mTc-DTPA captopril renography and duplex ultrasound findings in diagnosis of renal artery stenosis before angiography, that is used as "gold standard". "
3.	AngiotensinsIBA 03/01/2002 - "ACE inhibition is superior to angiotensin receptor blockade for renography in renal artery stenosis." 07/01/2002 - "The present study was undertaken to clarify the role of intrarenal angiotensin (Ang) II and its generating pathways in clipped and nonclipped kidneys of 4-week unilateral renal artery stenosis in anesthetized dogs. " 05/01/1997 - "In the presence of renal artery stenosis, glomerular filtration is maintained by angiotensin. " 02/01/1996 - "Genetic risk for renal artery stenosis: association with deletion polymorphism in angiotensin 1-converting enzyme gene." 02/01/1995 - "We hypothesized that this angiotensin dependence is due to enhanced responsiveness to the slow pressor effect of Ang II caused by renal artery stenosis. "
4.	CreatinineIBA 11/01/1987 - "Patients with bilateral renal artery stenosis, mild azothemia and moderately elevated creatinine, were found to improve significantly their renal function post operatively. " 01/01/2009 - "We illustrate with data from 2 studies: one is a study of the performance of hearing screening tests for infants, and the other concerns the value of serum creatinine in diagnosing renal artery stenosis." 01/01/2001 - "This is an observational and multicentre study carried out during a 14-month follow-up period in 20 hospitals in SPAIN: Inclusion criteria were the presence of bilateral renal artery stenosis > 50% and a creatinine level of > or = 1.5 mg/dl. " 08/01/2000 - "Patients with clinically relevant cardiac valvular disease, documented or suspected renal artery stenosis, and a serum creatinine level >2.5 mg/dL were excluded from the study. " 01/01/1999 - "The aim of this study was to evaluate the effect of renal artery stenosis (RAS) correction in hypertensive patients on 24 h SBP, 24 h DBP, creatinine clearance (GFR), urinary albumin excretion (UAE) and LV morphology and mass (LVMI). "
5.	AldosteroneIBA 01/01/1981 - "Unilateral operation, performed in 11 of the remaining 21 patients, was followed by normalization of BP in 3 and no response in 8. Bilateral reconstructive surgery, performed in 10 patients, resulted in normotension in 2 and improvement in 7. Our studies indicate that determination of peripheral PRA and/or urinary aldosterone can serve as a useful prognostic indicator after surgery in hypertensive patients with renal artery stenosis." 10/01/1967 - "[Aldosterone metabolism in renal artery stenosis]." 01/01/1967 - "[Aldosterone metabolism and renal hemodynamics during renal artery stenosis]." 01/01/1966 - "[Variations of urinary aldosterone before and after intervention in a case of right renal artery stenosis with the hypertensive syndrome]." 06/01/1963 - "The rate of aldosterone secretion in hypertensive patients with demonstrable renal artery stenosis."
6.	gadodiamide (Omniscan)FDA Link 12/01/2007 - "To determine the most efficacious dose of gadodiamide for three-dimensional (3D) contrast-enhanced (CE) magnetic resonance angiography (MRA) of the renal arteries on a patient level based on the sensitivity in detecting the main hemodynamically relevant (> or =50% or occlusion) renal artery stenosis (RAS) using intra-arterial digital subtraction angiography (IA DSA) as the gold standard. " 02/01/2010 - "To evaluate the efficacy and safety of 0.1 mmol/kg gadodiamide administration for contrast-enhanced magnetic resonance angiography (MRA) in detecting hemodynamically relevant renal artery stenosis (RAS) when compared with intraarterial digital subtraction angiography (IA-DSA) as the gold standard. " 02/01/2010 - "Comparison of gadodiamide-enhanced MR angiography to intraarterial digital subtraction angiography for evaluation of renal artery stenosis: results of a phase III multicenter trial." 05/01/2001 - "Safety of CO(2)- and gadodiamide-enhanced angiography for the evaluation and percutaneous treatment of renal artery stenosis in patients with chronic renal insufficiency." 03/01/1999 - "To determine whether gadodiamide is a safe and useful angiographic contrast agent for help in diagnosis and percutaneous treatment of renal artery stenosis in patients with renal insufficiency. "
7.	GadoliniumIBA 05/01/2001 - "The purpose of this study was to assess the image quality of gadolinium-enhanced time-resolved three-dimensional (3D) MR angiography and to evaluate its accuracy in revealing renal artery stenosis. " 06/01/2000 - "The purpose of this study was to evaluate diagnostic accuracy and interobserver variability of time-resolved three-dimensional gadolinium-enhanced MR angiography in the detection of renal artery stenosis in comparison with intraarterial digital subtraction angiography as the standard of reference. " 03/01/2000 - "The purpose of this study was to evaluate the accuracy of breath-hold contrast-enhanced MR angiography in the assessment of renal artery stenosis and accessory renal arteries using a standard dose of gadolinium. " 11/01/1999 - "The aim of our study was to evaluate a three-dimensional gadolinium-enhanced breath-hold MR angiography sequence using standard MR gradients in detecting renal artery stenosis. " 07/01/1997 - "The purpose of this study was to compare dynamic gadolinium-enhanced three-dimensional spoiled gradient-recalled MR angiography with conventional arteriography in the evaluation of proximal renal artery stenosis (RAS). "
8.	Peptidyl-Dipeptidase A (Angiotensin Converting Enzyme)IBA 09/01/2005 - "Radionuclide renography with angiotensin converting enzyme (ACE) inhibition plays an important role in the diagnosis of haemodynamically significant renal artery stenosis. " 05/01/2004 - "Angiotensin-converting enzyme inhibitor usage in patients with incidental atherosclerotic renal artery stenosis." 07/01/1999 - "Measurement of the resistive index after administration of an angiotensin converting enzyme inhibitor in humans may improve the performance of Doppler ultrasonography in detecting hemodynamically significant renal artery stenoses." 07/01/1999 - "Effect of angiotensin converting enzyme inhibition on the Doppler waveform in dogs with renal artery stenosis." 04/01/1999 - "Pharmacological intervention to exclude obstruction (diuretic renogram) or hemodynamically significant renal artery stenosis (angiotensin converting enzyme challenge) should be used whenever indicated."
9.	Pentetic Acid (DTPA)FDA LinkGeneric 12/01/1986 - "Renal DTPA studies were analysed to produce numerical data of renal function (blood flow, glomerular filtration, and excretion), and this was used as an adjunct to the routine imaging information in a study of renal artery stenosis (RAS). " 08/01/1985 - "Thus, in this model we find the computer-assisted 90-sec [99mTc]DTPA renal flow study to be superior to conventional [131I]hippuran renography in the diagnosis of moderate-to-severe unilateral renal artery stenosis." 01/01/2014 - "Renal artery stenosis was excluded by renal artery Doppler, DTPA scan and angiography. " 09/01/2004 - "Renal DTPA scans suggested functionally significant renal artery stenosis in only 48% of patients but the clinical responses suggested that this was an underestimate. " 02/01/2001 - "Superiority of tc-99m MAG3 to tc-99m DTPA in treating a patient with mild renal artery stenosis."
10.	Furosemide (Lasix)FDA LinkGeneric 01/01/1990 - "Results of quantification of frusemide response in 123I-hippuran renal studies of unilateral renal artery stenosis." 01/01/2014 - "Increases in renal oxygenation in response to a standard 20 mg intravenous furosemide stimulus have been evaluated to assess kidney viability in patients with renal artery stenosis (RAS). " 03/01/2012 - "Nine hypertensive patients and 11 domestic pigs, some with renal artery stenosis, were studied using BOLD MRI before and after injection of furosemide, which reduces medullary oxygen consumption. " 09/01/1991 - "However, the best results in predicting the response to angioplasty or surgery in patients with renal artery stenosis have been with the use of post-ACEI hippuran in combination with furosemide (sensitivity, 96%; specificity, 95%). " 03/01/2003 - "A high-salt diet reduced expression of COX-2, whereas a low-salt diet, furosemide infusion, and renal artery stenosis stimulated COX-2 expression. "

Therapies and Procedures

1.	Angioplasty (Angioplasty, Transluminal) 09/01/2011 - "The Angioplasty and Stenting for Renal Artery Lesions (ASTRAL) trial was conducted to answer the question of whether medical therapy or angioplasty and stenting is the best treatment for hemodynamically significant renal artery stenosis. " 12/01/1994 - "The best treatment for ischemic nephropathy due to renal artery stenosis [conservative, angioplasty, surgery] is unknown because appropriately controlled trials are lacking. " 12/01/1998 - "In conclusion, most patients with TRAS can be treated successfully with percutaneous transluminal angioplasty as the initial interventional treatment of choice for high-grade renal artery stenosis, and surgical revascularization is indicated when percutaneous transluminal angioplasty cannot be done or is unsuccessful." 04/01/2012 - "Percutaneous transluminal renal angioplasty is a safe procedure for atherosclerotic renal artery stenosis patients, providing a significant improvement in blood pressure control and reduction in the number of oral antihypertensive medications." 12/01/1990 - "If a hypertensive patient with renal artery stenosis (RAS) is to benefit from percutaneous transluminal renal angioplasty (PTRA) in terms of a sustained improvement in blood pressure control, one may postulate a demonstrable reduction in renal blood flow (RBF) to that kidney, reversible by PTRA. "
2.	Stents 12/01/2001 - "Implantation of metal stents is a safe and effective method for the treatment of atherosclerotic renal artery stenosis and certainly presents an important alternative to renal PTA." 05/15/1995 - "These follow-up data of a prospective, nonrandomized, observational study showed that stent recanalization of atherosclerotic renal artery stenoses was beneficial with regard to renal function and blood pressure response, and had a restenosis incidence of 25%." 05/01/2001 - "Technical performance and delivery characteristics of the Palmaz-Corinthian stent have been significantly improved compared to the Palmaz design, allowing mostly correct placement in renal artery stenoses with a low complication rate." 02/13/1997 - "The favorable early and long-term results suggest that primary stent placement is an effective treatment for renal-artery stenosis involving the ostium." 11/01/2001 - "Insertion of renal artery stents is a safe and effective treatment for renal artery stenosis."
3.	Transplants (Transplant) 06/01/1996 - "Posttreatment renal function was stable or improved in 18 patients, while renal function deteriorated due to parenchymal disease in 3. Most patients with transplant renal artery stenosis can be treated successfully. " 02/01/1982 - "Four patients with main renal artery stenosis had successful, uncomplicated PTD with no graft loss, a significant reduction in diastolic BP (pre 108 +/- 10 mm Hg, post 88 +/- 5 mm Hg, P less than .05) and less antihypertensive drug requirement (pre 3.0 +/- .8 drugs, post 1.0 +/- .8 drugs, P less than .05). " 08/01/2013 - "These results demonstrate that this renovascular graft holds a great therapeutic promise for renal artery stenosis." 05/01/2006 - "This study evaluated the efficacy of primary endovascular stenting in cases of transplant renal artery stenosis (TRAS) from cadaver and non-heart-beating donor kidneys. " 05/01/1984 - "Each of five patients with transplant renal artery stenosis had two operations; four were cured or improved. "
4.	Balloon Angioplasty 01/01/2003 - "Available data are insufficient to conclude that balloon angioplasty is superior to medical therapy in lowering blood pressure of patients with renal artery stenosis in whom blood pressure can be controlled with medical therapy. " 01/01/2003 - "Balloon angioplasty is widely used for the treatment of hypertensive patients with renal artery stenosis. " 01/01/1998 - "It is suggested that stenting is a very useful adjunct to balloon angioplasty in the treatment of renal artery stenosis due to FMD." 07/01/2007 - "We examined the efficacy of conventional balloon angioplasty and cutting balloon angioplasty (CBA) for the treatment of non-arteriosclerotic renal artery stenosis (RAS). " 06/01/2005 - "Since balloon angioplasty for renal artery stenosis has a medication-sparing effect, it may lead to an improvement in quality of life. "
5.	Nephrectomy 01/01/1981 - "Because renal function had deteriorated slightly after the first operation and improved after the second, a comparison was made of the effects of unilateral nephrectomy and reconstructive surgery on renal function in a further 26 patients with renal artery stenosis. " 12/01/1990 - "In the second study, evidence of regeneration was sought in atrophic kidneys after surgical reversal of renal artery stenosis and, in other animals, after unilateral nephrectomy of the contralateral kidney. " 01/01/2011 - "[Case of renal artery stenosis in an elderly patient after nephrectomy diagnosed by ultrasound sonography, showing improvement of blood pressure and renal dysfunction after renal artery stenting]." 02/01/2007 - "We report a case involving renal artery stenosis after open partial nephrectomy on a solitary kidney." 05/01/2005 - "Renal angiography showed right main renal artery stenosis, abnormal intrarenal arteries, and nonfunctional right kidney; the patient subsequently underwent right nephrectomy with good effect. "