What is the effect of chronic ischemia in the pathophysiology of renal artery stenosis (RAS)?

Updated: Nov 02, 2020
  • Author: Bruce S Spinowitz, MD, FACP; Chief Editor: Vecihi Batuman, MD, FASN  more...
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Answer

In patients with renal artery stenosis, the chronic ischemia produced by the obstruction of renal blood flow leads to adaptive changes in the kidney that are more pronounced in the tubular tissue. These changes include atrophy with the following:

  • Decreased tubular cell size
  • Patchy inflammation and fibrosis
  • Tubulosclerosis
  • Atrophy of the glomerular capillary tuft
  • Thickening and duplication of the Bowman capsule
  • Intrarenal arterial medial thickening

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