University of miami division of clinical pharmacology therapeutic rounds: Ischemic renal disease

Richard A Preston, Murray Epstein

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Ischemic renal disease (IRD) is defined as a significant reduction in glomerular filtration rate and/or loss of renal parenchyma caused by hemodynamically significant renal artery stenosis. IRD is a common and often overlooked clinical entity that presents in the setting of extrarenal arteriosclerotic vascular disease in older individuals with azotemia. IRD is an important cause of chronic renal failure and end-stage renal disease (ESRD), and many patients with a presumed diagnosis of hypertensive nephrosclerosis may actually have undiagnosed ischemic nephropathy as the cause of their ESRD. The primary reason for establishing the diagnosis of IRD is the hope that correction of a renal artery stenosis will lead to improvement of renal function or a delay in progression to ESRD. There are six typical clinical settings in which the clinician could suspect IRD: acute renal failure caused by the treatment of hypertension, especially with angiotensin-converting enzyme inhibitors; progressive azotemia in a patient with known renovascular hypertension; acute pulmonary edema superimposed on poorly controlled hypertension and renal failure; progressive azotemia in an elderly patient with refractory or severe hypertension; progressive azotemia in an elderly patient with evidence of atherosclerotic disease; and unexplained progressive azotemia in an elderly patient. It is important for the clinician to identify IRD, because IRD represents a potentially reversible cause of chronic renal failure in a hypertensive patient.

Original languageEnglish
Pages (from-to)203-210
Number of pages8
JournalAmerican Journal of Therapeutics
Volume5
Issue number3
DOIs
StatePublished - May 1 1998

Fingerprint

Clinical Pharmacology
Azotemia
Kidney
Chronic Kidney Failure
Renal Artery Obstruction
Therapeutics
Hypertension
Nephrosclerosis
Renovascular Hypertension
Pulmonary Edema
Glomerular Filtration Rate
Vascular Diseases
Angiotensin-Converting Enzyme Inhibitors
Acute Kidney Injury
Renal Insufficiency

Keywords

  • Arteriosclerosis
  • End-stage renal disease
  • Hypertension
  • Ischemic renal disease
  • Renovascular hypertension

ASJC Scopus subject areas

  • Pharmacology

Cite this

University of miami division of clinical pharmacology therapeutic rounds : Ischemic renal disease. / Preston, Richard A; Epstein, Murray.

In: American Journal of Therapeutics, Vol. 5, No. 3, 01.05.1998, p. 203-210.

Research output: Contribution to journalArticle

@article{99ae2cf59d2644ed89c7ab40736b2aa5,
title = "University of miami division of clinical pharmacology therapeutic rounds: Ischemic renal disease",
abstract = "Ischemic renal disease (IRD) is defined as a significant reduction in glomerular filtration rate and/or loss of renal parenchyma caused by hemodynamically significant renal artery stenosis. IRD is a common and often overlooked clinical entity that presents in the setting of extrarenal arteriosclerotic vascular disease in older individuals with azotemia. IRD is an important cause of chronic renal failure and end-stage renal disease (ESRD), and many patients with a presumed diagnosis of hypertensive nephrosclerosis may actually have undiagnosed ischemic nephropathy as the cause of their ESRD. The primary reason for establishing the diagnosis of IRD is the hope that correction of a renal artery stenosis will lead to improvement of renal function or a delay in progression to ESRD. There are six typical clinical settings in which the clinician could suspect IRD: acute renal failure caused by the treatment of hypertension, especially with angiotensin-converting enzyme inhibitors; progressive azotemia in a patient with known renovascular hypertension; acute pulmonary edema superimposed on poorly controlled hypertension and renal failure; progressive azotemia in an elderly patient with refractory or severe hypertension; progressive azotemia in an elderly patient with evidence of atherosclerotic disease; and unexplained progressive azotemia in an elderly patient. It is important for the clinician to identify IRD, because IRD represents a potentially reversible cause of chronic renal failure in a hypertensive patient.",
keywords = "Arteriosclerosis, End-stage renal disease, Hypertension, Ischemic renal disease, Renovascular hypertension",
author = "Preston, {Richard A} and Murray Epstein",
year = "1998",
month = "5",
day = "1",
doi = "10.1097/00045391-199805000-00012",
language = "English",
volume = "5",
pages = "203--210",
journal = "American Journal of Therapeutics",
issn = "1075-2765",
publisher = "Lippincott Williams and Wilkins",
number = "3",

}

TY - JOUR

T1 - University of miami division of clinical pharmacology therapeutic rounds

T2 - Ischemic renal disease

AU - Preston, Richard A

AU - Epstein, Murray

PY - 1998/5/1

Y1 - 1998/5/1

N2 - Ischemic renal disease (IRD) is defined as a significant reduction in glomerular filtration rate and/or loss of renal parenchyma caused by hemodynamically significant renal artery stenosis. IRD is a common and often overlooked clinical entity that presents in the setting of extrarenal arteriosclerotic vascular disease in older individuals with azotemia. IRD is an important cause of chronic renal failure and end-stage renal disease (ESRD), and many patients with a presumed diagnosis of hypertensive nephrosclerosis may actually have undiagnosed ischemic nephropathy as the cause of their ESRD. The primary reason for establishing the diagnosis of IRD is the hope that correction of a renal artery stenosis will lead to improvement of renal function or a delay in progression to ESRD. There are six typical clinical settings in which the clinician could suspect IRD: acute renal failure caused by the treatment of hypertension, especially with angiotensin-converting enzyme inhibitors; progressive azotemia in a patient with known renovascular hypertension; acute pulmonary edema superimposed on poorly controlled hypertension and renal failure; progressive azotemia in an elderly patient with refractory or severe hypertension; progressive azotemia in an elderly patient with evidence of atherosclerotic disease; and unexplained progressive azotemia in an elderly patient. It is important for the clinician to identify IRD, because IRD represents a potentially reversible cause of chronic renal failure in a hypertensive patient.

AB - Ischemic renal disease (IRD) is defined as a significant reduction in glomerular filtration rate and/or loss of renal parenchyma caused by hemodynamically significant renal artery stenosis. IRD is a common and often overlooked clinical entity that presents in the setting of extrarenal arteriosclerotic vascular disease in older individuals with azotemia. IRD is an important cause of chronic renal failure and end-stage renal disease (ESRD), and many patients with a presumed diagnosis of hypertensive nephrosclerosis may actually have undiagnosed ischemic nephropathy as the cause of their ESRD. The primary reason for establishing the diagnosis of IRD is the hope that correction of a renal artery stenosis will lead to improvement of renal function or a delay in progression to ESRD. There are six typical clinical settings in which the clinician could suspect IRD: acute renal failure caused by the treatment of hypertension, especially with angiotensin-converting enzyme inhibitors; progressive azotemia in a patient with known renovascular hypertension; acute pulmonary edema superimposed on poorly controlled hypertension and renal failure; progressive azotemia in an elderly patient with refractory or severe hypertension; progressive azotemia in an elderly patient with evidence of atherosclerotic disease; and unexplained progressive azotemia in an elderly patient. It is important for the clinician to identify IRD, because IRD represents a potentially reversible cause of chronic renal failure in a hypertensive patient.

KW - Arteriosclerosis

KW - End-stage renal disease

KW - Hypertension

KW - Ischemic renal disease

KW - Renovascular hypertension

UR - http://www.scopus.com/inward/record.url?scp=0031832420&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0031832420&partnerID=8YFLogxK

U2 - 10.1097/00045391-199805000-00012

DO - 10.1097/00045391-199805000-00012

M3 - Article

C2 - 10099060

AN - SCOPUS:0031832420

VL - 5

SP - 203

EP - 210

JO - American Journal of Therapeutics

JF - American Journal of Therapeutics

SN - 1075-2765

IS - 3

ER -