Medical therapy for renal artery stenosis

Author(s): William R Colyer Jr, Christopher J Cooper

The management of renal artery stenosis remains controversial with randomized trials suggesting that revascularization is no better than medical therapy. Thus all patients with atheromatous renovascular disease should be treated with medical therapy. However optimal therapy has not been clearly defined by atheromatous renovascular disease trials; despite this, there are data to support the use of several pharmacologic agents among this group of patients. Such a regimen should include an angiotensin-converting enzyme inhibitor or angiotensin-receptor blocker, a b-blocker, a statin and aspirin. Additional therapies will often be required and need to be individualized to a given patient based upon comorbid conditions.