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In-Stent Restenosis of the Renal Artery in a Single Kidney Patient: The Role of ACEI in the Therapeutic Choice

Department of Nephrology, University of Rome "La Sapienza,, ciancirosario{at}tin.it

Antonietta Gigante, MD

Department of Nephrology, University of Rome "La Sapienza

Lelio Polidori, MD

Department of Nephrology, University of Rome "La Sapienza

Domenico Di Donato, MD

Department of Nephrology, University of Rome "La Sapienza

Paola Martina, MD

Department of Nephrology, University of Rome "La Sapienza

Biagio Barbano, MD

Department of Nephrology, University of Rome "La Sapienza

Roberta Renzulli, MD

Department of Nephrology, University of Rome "La Sapienza

Alvaro Zaccaria, MD

Vascular Surgery, S. Pietro Fatebenefratelli Hospital Rome

Giorgio Fuiano, MD

University Magna Graecia, Catanzaro Italy

Renal artery stenosis (RAS) caused by atherosclerotic changes of the renal arteries has become a concern as a cause of end-stage renal failure. Percutaneous balloon angioplasty with or without endovascular stenting is an increasingly accepted procedure at the expense of classical approaches such as aortorenal bypass and other types of surgery. Renal percutaneous transluminal angioplasty and stenting (RPTAS) represent the first therapeutic choice; however, there is doubt regarding the satisfactory long-term outcome for primary RPTAS. Currently, there is no clear evidence whether or not RPTAS prevents further progressive renal function decline because comparisons between interventional randomized studies and medical therapy are still lacking. Despite the fact that the use of angiotensin-converting enzyme inhibitors (ACEIs) may be a potential cause of acute renal failure, clinical data suggest that ACEI therapy is associated with better survival in patient with RAS. In our case, the use of ACEIs has been fundamental for the indirect evaluation of restenosis degree and RPTAS.

Key Words: hypertension • secondary renal disease • renal ischemia • renal artery stenosis

This version was published on August 1, 2009

Angiology, Vol. 60, No. 4, 496-503 (2009)
DOI: 10.1177/0003319708322172


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