Yerram P, Karuparthi P R, Chaudhary K
Department of Internal Medicine, University of Missouri, Columbia, MO, USA.
Minerva Urol Nefrol. 2012 Mar;64(1):63-72.
Renovascular disease is an important cause of secondary hypertension and renal impairment. Atherosclerotic renal artery stenosis (ARAS) is the most important cause of renal artery stenosis (RAS), and has been linked to increased cardiovascular risk. The pathogenesis of renovascular hypertension is complex, but is mainly due to the over-activation of Renin-Angiotensin-Aldosterone system. A major consequence of untreated RAS is ischemic nephropathy, which is due to the sustained reduction in renal perfusion leading to derangement of microvascular function, and eventual development of interstitial fibrosis. Diagnosis of these conditions can be complex, sometimes needing invasive testing. Aggressive medical management is key to preventing progression of disease, as the role of revascularization in the management of ARAS is still not well defined.
肾血管疾病是继发性高血压和肾功能损害的重要原因。动脉粥样硬化性肾动脉狭窄（ARAS）是肾动脉狭窄（RAS）的最重要原因，并与心血管风险增加有关。肾血管性高血压的发病机制复杂，但主要是由于肾素-血管紧张素-醛固酮系统过度激活。未经治疗的RAS的一个主要后果是缺血性肾病，这是由于肾灌注持续减少导致微血管功能紊乱，最终发展为间质纤维化。这些疾病的诊断可能很复杂，有时需要进行侵入性检查。积极的药物治疗是预防疾病进展的关键，因为血管重建在ARAS治疗中的作用仍未明确。
