Renal Artery Vasculopathy: Case Study and Literature Review

Abstract

Non-atherosclerotic renal artery vasculopathies are rare and can be caused by heterogenous group of diseases, some of which has bad prognosis. The literature addressing this rare group of disease is scarce. A single center analysis of all adult patients evaluated for renal artery disease including dissection, aneurysm, stenosis, vasculitis, thrombosis, irregularity, and renal infarct treated at our center, from January 2000 to April 2022. Baseline data collected included demographics, comorbidities, vital signs, laboratory values, pathology, genetic testing, and imaging results/diagnoses. Additionally, treatment modality, follow-up, and symptom relief/recurrence from follow-up visits were collected if available. Out of the included 227 patients, 91 (40%) had renal infarction, 70 (31%) had renal artery dissection, 69 (30%) had aneurysm, 33 (15%) had stenosis, and 32 (14%) had thrombosis. The most common diagnoses were fibromuscular dysplasia (n = 86, 38%) and thromboembolism (n = 38, 17%). Most patients improved with conservative management, reserving endovascular or surgical interventions for symptomatic patients with more complicated presentations. To our knowledge, this is the only case study and general review in the literature that addresses the diagnosis and management of non-atherosclerotic renal arteriopathies showing good outcome for most of the underlying etiologies.