Which medications are used for 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

The general approach to therapy of ischemic nephropathy involves control of hypertension, preferably with angiotensin-converting enzyme (ACE) inhibitors or angiotensin receptor blockers (ARBs). Unfortunately, these two classes of drugs may lead to increased serum creatinine levels and hyperkalemia, limiting their utility. In this case, calcium channel blockers are likely the most useful and best-tolerated agents.

Initiate strict control of serum cholesterol, which usually requires the use of statins, as with all conditions associated with atherosclerosis. A study by Bianchi et al suggested that statins, in addition to ACE inhibitors and ARBs, may reduce proteinuria and slow the progression of kidney disease. [59]


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