Nierenarterienstenose: Neue Erkenntnisse und Entwicklungen

Was ist neu?

• Diagnostik der Niereninsuffizienz: Die geschätzte glomeruläre Filtrationsrate (eGFR) ist zu ungenau für eine zuverlässige Verlaufskontrolle der Nierenfunktion vor und nach Revaskularisation einer NAST im Vergleich zur (125)I-Iothalamat-GFR (iGFR).

• Duplexsonographische Kriterien zur Bestimmung einer Instent-Restenose: Direkte duplexsonographische Grenzwerte einer hämodynamisch relevanten NAST sind höher als für De-Novo-Stenosen in Nativgefäßen.

• Nierenarterien-Stenting: Bei NAST > 60 % zeigt die Stent-Revaskularisierung im Vergleich zur alleinigen medikamentösen Therapie keine zusätzlichen Vorteile.

• Stentangioplastie von NAST bei terminaler Niereninsuffizienz: Bei 8 Patienten normalisierte sich der zuvor unter Medikation therapieresistente Blutdruck nach der Stentangioplastie von NAST.

Schlüsselwörter

Nierenarterienstenose - arterielle Hypertonie - Niereninsuffizienz - Stent - Überleben

Key Words

renal artery stenosis - arterial hypertension - renal insufficiency - stent - survival

• Literaturverzeichnis

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