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==Overview==
==Overview==
Resistant hypertension and a decrease in eGFR in a patient known to have atherosclerosis are 3 elements that are very important to raise the suspicion of ARAS. Other factors, such as hypertension at an early age or malignant hypertension, play a major role as well.
Resistant hypertension and a decrease in estimated [[glomerular filtration rate]] (eGFR) in a patient known to have [[atherosclerosis]] are 3 elements that are very important to raise the suspicion of atherosclerotic renal artery stenosis. Other factors, such as [[hypertension]] at an early age or [[malignant hypertension]], play a major role as well.


==History and symptoms==
==History and symptoms==
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Additional clinical clues that suggest renal artery disease are listed below<ref name="pmid15114537">{{cite journal| author=Kidney Disease Outcomes Quality Initiative (K/DOQI)| title=K/DOQI clinical practice guidelines on hypertension and antihypertensive agents in chronic kidney disease. | journal=Am J Kidney Dis | year= 2004 | volume= 43 | issue= 5 Suppl 1 | pages= S1-290 | pmid=15114537 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15114537 }} </ref>:
Additional clinical clues that suggest renal artery disease are listed below<ref name="pmid15114537">{{cite journal| author=Kidney Disease Outcomes Quality Initiative (K/DOQI)| title=K/DOQI clinical practice guidelines on hypertension and antihypertensive agents in chronic kidney disease. | journal=Am J Kidney Dis | year= 2004 | volume= 43 | issue= 5 Suppl 1 | pages= S1-290 | pmid=15114537 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15114537 }} </ref>:
*Age of hypertension < 30 years and > 55 years
*Age of [[hypertension]] < 30 years and > 55 years
*Abrupt onset of hypertension
*Abrupt onset of [[hypertension]]
*Accelerated hypertension that was previously well-controlled
*Accelerated [[hypertension]] that was previously well-controlled
*Refractory hypertension to 3 anti-hypertensive medications
*Refractory [[hypertension]] to 3 anti-hypertensive medications
*Malignant hypertension
*[[Malignant hypertension]]
*Smoking  
*[[Smoking]]
*Abdominal bruit
*Abdominal bruit
*Flash pulmonary edema
*[[Flash pulmonary edema]]
*Generalized atherosclerosis obliterans
*Generalized atherosclerosis obliterans
*Asymmetric kidney sizes  
*Asymmetric kidney sizes  
*AKI when ACE-I or ARB are used for treatment
*[[Acute kidney injury]] when ACE-I or ARB are used for treatment


==References==
==References==

Revision as of 01:23, 15 May 2014

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Yazan Daaboul, Serge Korjian

Overview

Resistant hypertension and a decrease in estimated glomerular filtration rate (eGFR) in a patient known to have atherosclerosis are 3 elements that are very important to raise the suspicion of atherosclerotic renal artery stenosis. Other factors, such as hypertension at an early age or malignant hypertension, play a major role as well.

History and symptoms

According to the KDOQI Clinical Practice Guidelines on Hypertension and Antihypertensive Agents in Chronic Kidney Disease[1], the most important clinical clues that should raise the suspicion of renal artery disease are the triad:

Most Important Clinical Clues
  • Resistant hypertension
  • Reduction in estimated glomerular filtration rate (eGFR)
  • Known generalized atherosclerosis


Additional clinical clues that suggest renal artery disease are listed below[1]:

References

  1. 1.0 1.1 Kidney Disease Outcomes Quality Initiative (K/DOQI) (2004). "K/DOQI clinical practice guidelines on hypertension and antihypertensive agents in chronic kidney disease". Am J Kidney Dis. 43 (5 Suppl 1): S1–290. PMID 15114537.