Atherosclerotic renal artery stenosis

Atherosclerotic renal artery stenosis (RAS) is a secondary cause of hypertension (1). RAS causes renal ischemia which leads to renin release from the juxtaglomerular cells of the kidneys (2). Renin release activates conversion of angiotensin I to angiotensin II and increases adrenal gland release of aldosterone (3). Angiotensin II causes vasoconstriction, and aldosterone causes increased retention of sodium and water, both leading to renovascular hypertension (RVHT) (3). RVHT occurs in 1% to 5% of persons with hypertension and in 20% to 40% of persons with severe refractory hypertension or persons having diagnostic coronary angiography (4). Atherosclerotic RAS is the most common cause of RVHT (5).