Renal artery stenosis epidemiology and demographics

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Shivam Singla, M.D.[2] Yazan Daaboul, Serge Korjian


Atherosclerotic renal artery stenosis (ARAS) is considered a disease of the elderly. The true prevalence of ARAS has not been reliably determined and prevalence rates present so far may in fact be an underestimate or an overestimate of the true prevalence due to selection criteria in different studies. The prevalence of ARAS increases substantially among patients with cardiovascular co-morbidities, such as diabetes mellitus, dyslipidemia, essential hypertension, and known coronary or peripheral artery disease.

Epidemiology and demographics

Renal artery stenosis considered a disease of the elderly.[1] It most commonly affects patients with cardiovascular co-morbidities, such as those with diabetes mellitus, coronary and peripheral artery disease, dyslipidemia, essential hypertension, and smoking history.[2][3][4][5]

  • It is difficult to assess the real incidence and prevalence of renal artery stenosis because most patients with the disease are in fact asymptomatic.
  • In one study that involved 14,152 patients undergoing abdominal aortography, approximately 10% of the patients had RAS and 1.3% had bilateral RAS, 60% of which were considered significant stenosis.[5]
  • Autopsy findings among 5194 patients between 1980 and 1988 showed that 4.3% of all patients RAS, most of which were not diagnosed.[2] The frequency of RAS among patients with diabetes and hypertension was higher, reaching up to 10% of all patients. [2]
  • Atherosclerotic renal artery stenosis affects approximately 0.5-7% of the U.S. population above the age of 65 years. It is present in almost 5% of patients with chronic kidney disease.[6][7]
  • Although stenosis may progress in 30-53% of patients within only 2-5 years. after diagnosis, only 3-15% of patient with ARAS progress to total occlusion of the renal arteries.[4][3][4][8][9] The definition of disease progression, however, may vary between individual studies.
  • To date, there is no reliable information about the prevalence of secondary hypertension due to renal artery stenosis. Follow-up and prognosis for hypertensive patients with renal artery stenosis has not yet been achieved.


  1. Safian RD, Textor SC (2001). "Renal-artery stenosis". N Engl J Med. 344 (6): 431–42. doi:10.1056/NEJM200102083440607. PMID 11172181.
  2. 2.0 2.1 2.2 Sawicki PT, Kaiser S, Heinemann L, Frenzel H, Berger M (1991). "Prevalence of renal artery stenosis in diabetes mellitus--an autopsy study". J Intern Med. 229 (6): 489–92. PMID 2045754.
  3. 3.0 3.1 Dean RH, Kieffer RW, Smith BM, Oates JA, Nadeau JH, Hollifield JW; et al. (1981). "Renovascular hypertension: anatomic and renal functon changes during drug therapy". Arch Surg. 116 (11): 1408–15. PMID 7305653.
  4. 4.0 4.1 4.2 Tollefson DF, Ernst CB (1991). "Natural history of atherosclerotic renal artery stenosis associated with aortic disease". J Vasc Surg. 14 (3): 327–31. PMID 1880841.
  5. 5.0 5.1 Crowley JJ, Santos RM, Peter RH, Puma JA, Schwab SJ, Phillips HR; et al. (1998). "Progression of renal artery stenosis in patients undergoing cardiac catheterization". Am Heart J. 136 (5): 913–8. PMID 9812088.
  6. Kalra PA, Guo H, Kausz AT, Gilbertson DT, Liu J, Chen SC; et al. (2005). "Atherosclerotic renovascular disease in United States patients aged 67 years or older: risk factors, revascularization, and prognosis". Kidney Int. 68 (1): 293–301. doi:10.1111/j.1523-1755.2005.00406.x. PMID 15954920.
  7. Hansen KJ, Edwards MS, Craven TE, Cherr GS, Jackson SA, Appel RG; et al. (2002). "Prevalence of renovascular disease in the elderly: a population-based study". J Vasc Surg. 36 (3): 443–51. PMID 12218965.
  8. Caps MT, Zierler RE, Polissar NL, Bergelin RO, Beach KW, Cantwell-Gab K; et al. (1998). "Risk of atrophy in kidneys with atherosclerotic renal artery stenosis". Kidney Int. 53 (3): 735–42. doi:10.1046/j.1523-1755.1998.00805.x. PMID 9507221.
  9. Caps MT, Perissinotto C, Zierler RE, Polissar NL, Bergelin RO, Tullis MJ; et al. (1998). "Prospective study of atherosclerotic disease progression in the renal artery". Circulation. 98 (25): 2866–72. PMID 9860789.