What are the prerequisites for revascularization in the treatment 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

When kidney insufficiency is present and the objective is recovery of kidney function together with prevention of further kidney function impairment, the prerequisites for revascularization are as follows:

  • The serum creatinine level is lower than 4 mg/dL

  • The serum creatinine level is higher than 4 mg/dL but with a possible recent renal artery thrombosis

When either of those conditions is satisfied, the authors propose revascularization if the following apply:

  • The degree of stenosis is more than 80%

  • The serum creatinine level rises after administration of angiotensin-converting enzyme (ACE) inhibitors

  • The degree of stenosis is 50-80%, and the scintigraphy findings are positive


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