The relationship between renal artery stenosis and ischemic nephropathy

Ischemic nephropathy is defined as a clinically significant progressive reduction in glomerular filtration rate that is usually associated with significant renal artery stenosis (unilateral or bilateral involvement). Atherosclerotic renal artery disease is known as the most common cause of the ischemic nephropathy. These patients may develop secondary hypertension. In addition, epidemiologic data has showed a clear association between atherosclerotic renal artery stenosis and coronary artery disease and other cardiovascular disease. Despite the preserving function of kidney on various autoregulation processes, unusual microvascular function will be resulted due to sustained decline in renal perfusion. The ischemic nephropathy of asymptomatic cases may result in renovascular hypertension and renal failure. The reduction of renal function in these patients might be decreased or stopped by early appropriate diagnosis and also might be treated with renal artery angioplasty or surgery, after medical management. There is a debate about the occurrence of ischemic nephropathy as a result of atherosclerotic renal artery stenosis. In this study we aimed to review the prevalence of ischemic nephropathy due to atherosclerotic renal artery stenosis.