What are guidelines for first-line treatments 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

ACC/AHA, ESC and SCAI all prefer medical therapy as the first-line treatment for RAS. [56, 57, 58] ACC/AHA and ESC recommend ACE inhibitors, ARBs, and calcium channel blockers for unilateral RAS, [56, 57] but ESC advises that patients with bilateral severe RAS or RAS in a single functional kidney require very careful monitoring when started on ACE inhibitors or ARBs. [57]

The ACC/AHA also recommends beta-blockers for treatment of hypertension associated with RAS. [56] The ESC considers the use of antiplatelet agents to be part of best medical therapy. [57]


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