What are the most common treatments for renal artery stenosis?

In medicine, renal artery stenosis has many causes and is a type of renal vascular disease. Clinically, the main manifestations of this disease include renal vascular hypertension and ischemic nephropathy, and the greatest harm is the decline of renal function. So, now that medical technology is very advanced, what are the treatments for renal artery stenosis?

1. Angioplasty

Percutaneous transluminal renal angioplasty (PTRA, using a balloon to dilate the renal artery) is often performed. This treatment is particularly suitable for patients with fibromuscular dysplasia. Since patients with atherosclerosis and large artery inflammation are prone to restenosis after dilation, which may lead to treatment failure, these patients should have a vascular stent placed after dilation.

2. Surgery

These include endarterectomy, bypass surgery, and autologous kidney transplantation to restore blood supply to the diseased kidney.

3. Internal medicine drug treatment

Drug therapy cannot prevent the progression of renal artery stenosis, but it can help control hypertension and improve symptoms. For patients with unilateral renal artery stenosis and high renin, ACEI or ARB is often the first choice, but it must be started with a small dose and gradually increased to prevent the blood pressure from dropping too quickly or too low. Patients with bilateral renal artery stenosis should not take the above drugs. In order to effectively control blood pressure, a variety of antihypertensive drugs are often required. There are many modern powerful antihypertensive drugs, and drug therapy can often effectively control renal vascular hypertension. In addition, drug therapy is no different from PTRA in terms of patient long-term survival rate. Therefore, many scholars currently believe that drug therapy should be the first choice for renal vascular hypertension. As for renal artery stenosis that has already led to ischemic nephropathy, timely PTRA and vascular stent placement remain the first choice to prevent the stenosis and renal function damage from progressing. If PTRA is contraindicated or PTRA and stent placement fail, surgical treatment can be considered.