Atherosclerotic renovascular disease and progressive renal failure
Article Abstract:
Atherosclerotic renovascular disease is an important cause of end-stage kidney failure. It is characterized by stenosis, or narrowing, of the renal arteries and can be diagnosed conclusively only through arteriography. It is especially prevalent in patients over 50 and in those with generalized atherosclerosis. High blood pressure is present in only half of the people affected. Studies of the disease have found that it progresses in 29% to 71% of patients, and yearly it may account for 5% to 15% of the patients with end-stage kidney failure who begin dialysis. Restoring blood flow to the kidneys through surgery or percutaneous angioplasty can improve kidney function in these patients and may delay or prevent the need for dialysis. Medical treatment with angiotensin-converting enzyme (ACE) inhibitors lowers levels of angiotensin II, which is beneficial because elevated levels can worsen the disease. However, treatment should be carefully monitored because ACE inhibitors can damage the kidneys.
Publication Name: Annals of Internal Medicine
Subject: Health
ISSN: 0003-4819
Year: 1993
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Detection of renovascular hypertension: state of the art - 1992
Article Abstract:
Several tests may be effective and safe for the diagnosis of renovascular hypertension, or high blood pressure in the blood vessels of the kidneys. A review of the medical literature found that the captopril test and captopril scintigraphy with diethylenetriaminepentaacetic acid (DTPA) were the most sensitive and specific for diagnosing renovascular hypertension. Renal vein renin determination is another test with a high sensitivity and specificity. Intravenous pyelography is an effective diagnostic test, but it involves the use of radiation and dye. Intravenous angiography is expensive and also involves the injection of a dye into the kidney. Tests that need further investigation include duplex ultrasound and magnetic resonance angiography. Some tests are more effective than others in distinguishing renovascular hypertension from other conditions affecting the kidneys.
Publication Name: Annals of Internal Medicine
Subject: Health
ISSN: 0003-4819
Year: 1992
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Is hypertriglyceridemia a risk factor for atherosclerotic cardiovascular disease? A simple question with a complicated answer
Article Abstract:
Ongoing studies may determine the exact role of triglyceride levels in managing patients with hardened arteries or identifying potential patients. Current research suggests screening patients for triglyceride levels, encouraging patients with high levels to engage in a healthy lifestyle, and possibly treating patients with either niacin, CoA reductase inhibitors, or gemfibrozil. Associating a risk for vessel disease with the presence of triglyceride-rich particles may be misleading due to differences in particle number, size, and amount of associated cholesterol.
Publication Name: Annals of Internal Medicine
Subject: Health
ISSN: 0003-4819
Year: 1997
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