Bloch Michael J, Basile Jan
Department of Medicine, University of Nevada School of Medicine, 1500 East Second Street, Suite 302, Reno, NV 89502, USA.
Curr Atheroscler Rep. 2006 Sep;8(5):412-20. doi: 10.1007/s11883-006-0039-3.
Atherosclerotic renovascular disease (ARVD) is an increasingly common contributor to hypertension and renal failure. However, not all patients with an identified obstructive atherosclerotic renal artery stenosis will have clinical improvement, even after successful percutaneous intervention. As such, there remains extensive controversy regarding optimal diagnostic and treatment strategies. Part of this controversy is the result of a paucity of well-designed prospective, randomized clinical trials, but the complex nature of the disorder and the heterogeneity of patients presenting with possible ARVD make simple diagnostic and treatment paradigms difficult to develop. This narrative review describes the latest observations concerning the prevalence, pathogenesis, natural history, diagnostic studies, and treatment options for suspected ARVD. Hopefully, this knowledge will improve the ability of clinicians to weigh risks and benefits and determine the best strategy in individual patients.
动脉粥样硬化性肾血管疾病（ARVD）是导致高血压和肾衰竭的一个日益常见的因素。然而，并非所有已确诊为阻塞性动脉粥样硬化性肾动脉狭窄的患者，即使在成功进行经皮介入治疗后，临床症状都会有所改善。因此，关于最佳诊断和治疗策略仍存在广泛争议。这种争议部分源于缺乏精心设计的前瞻性、随机临床试验，但该疾病的复杂性以及可能患有ARVD的患者的异质性使得难以制定简单的诊断和治疗模式。这篇叙述性综述描述了有关疑似ARVD的患病率、发病机制、自然史、诊断研究和治疗选择的最新观察结果。希望这些知识能提高临床医生权衡风险和收益的能力，并为个体患者确定最佳策略。
