Article Sections

Introduction

Renal artery stenosis (RAS) is characterized by narrowing of one or both renal arteries, leading to reduced blood flow to the kidneys.  The hallmark of RAS is renovascular hypertension, a notable cause of secondary hypertension accounting for approximately 1%-5% of all cases.  RAS can also contribute to the development of chronic kidney disease (CKD).  Early recognition and management of RAS are crucial to prevent progressive renal damage and associated cardiovascular complications.

Pathophysiology

RAS involves narrowing of the renal artery lumen, which reduces renal blood flow and activates the renin-angiotensin-aldosterone system (RAAS) ( Figure 1).  This activation leads to systemic vasoconstriction and fluid retention, resulting in hypertension.  Hypertension occurs in both unilateral and bilateral disease, as renin secreted by the affected kidney leads to systemic effects, impacting both kidneys.

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