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 language | English |
|---|---|
| Pages (from-to) | 203-210 |
| Number of pages | 8 |
| Journal | American Journal of Therapeutics |
| Volume | 5 |
| Issue number | 3 |
| DOIs | |
| State | Published - May 1 1998 |
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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 journal › Article
}
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 -