Effect of renal revascularization on the development of renal dysfunction in atherosclerotic ischemic nephropathy

Chronic kidney disease (CKD) is characterized by a progressive loss of renal function and its main causes are hypertension and diabetes mellitus. Among the causes of hypertension is atherosclerotic renal disease (ARD). The development of CKD in patients with ARD appears to be due not only to the involvement of the main renal arteries, but also of the renal microcirculation, which may explain the fact that the success of the procedure does not guarantee an improvement in the progression of CKD. To date there is no evidence of benefit of angioplasty compared to medical treatment alone in patients with ARD. The present paper analyzes the most significant studies on renal outcomes in patients with ARD undergoing revascularization or medical treatment alone.

慢性肾脏病（Chronic kidney disease, CKD）以肾功能进行性减退为特征，其主要病因是高血压与糖尿病。动脉粥样硬化性肾病（atherosclerotic renal disease, ARD）是引发高血压的病因之一。ARD患者罹患CKD的机制不仅涉及肾主干动脉受累，还与肾微循环异常相关，这或可解释为何手术成功无法保证CKD病情进展得到改善。截至目前，尚无证据表明血管成形术（angioplasty）相较于单纯药物治疗，能为ARD患者带来获益。本文分析了当前针对接受血运重建术（revascularization）或单纯药物治疗的ARD患者肾脏转归的重要研究。