The CARI guidelines. Natural history and progression of atherosclerotic renal vascular stenosis.

• Atherosclerotic renovascular stenosis is a potentially progressive disease. • Risk factors for progressive stenosis and renal artery occlusion include: – uncontrolled systolic hypertension (>160 mmHg) – diabetes mellitus – high grade (>70%) ipsilateral and contralateral atherosclerotic renal vascular disease (ARVD), and – significant baseline proteinuria. • Risk factors for atrophy include: – systolic hypertension (>160 mmHg) – stenosis of more than 60%, and – decreased renal cortical blood flow. • Risk factors for decline in glomerular filtration rate (GFR) include: – abnormal baseline creatinine (>128 mmol/L) – bilateral ARVD or ARVD in solitary kidney. • Atherosclerotic renovascular stenosis is associated with high mortality and morbidity due to atherosclerosis elsewhere, particularly coronary artery disease.