When viewing this topic in a different language, you may notice some differences in the way the content is structured, but it still reflects the latest evidence-based guidance.

Estenose da artéria renal

Última revisión: 11 Sep 2025
Última actualización: 06 Jan 2023

Resumen

Definición

Anamnesis y examen

Principales factores de diagnóstico

  • presença dos principais fatores de risco
  • início da hipertensão com >55 anos
  • história de hipertensão acelerada, maligna ou resistente
  • história de disfunção renal inexplicada
  • história de doença arterial coronariana multivasos
  • história de doença vascular periférica
  • sopro abdominal
  • edema pulmonar recorrente súbito ou inexplicado
  • início da hipertensão com <30 anos
Todos los datos

Otros factores de diagnóstico

  • ausência de história familiar de hipertensão
  • outros sopros
  • história de lesão renal aguda após a administração do inibidor da enzima conversora da angiotensina (IECA) ou antagonista do receptor de angiotensina II
  • história de insuficiência cardíaca congestiva inexplicada
  • angina refratária
  • história de hipocalemia
Todos los datos

Factores de riesgo

  • dislipidemia
  • tabagismo
  • diabetes
  • sexo feminino
Todos los datos

Pruebas diagnósticas

Primeras pruebas diagnósticas para solicitar

  • creatinina sérica
  • potássio sérico
  • urinálise e avaliação do sedimento
  • razão aldosterona/renina
Todos los datos

Pruebas diagnósticas que deben considerarse

  • ultrassonografia duplex
  • angiografia por ressonância magnética (ARM) contrastada por gadolínio
  • Angiotomografia
  • angiografia convencional
  • angiografia de dióxido de carbono (CO2)
  • angiografia por ressonância magnética sem contraste
  • cintilografia renal com radionuclídeo e captopril
Todos los datos

Algoritmo de tratamiento

En curso

estenose da artéria renal (EAR) aterosclerótica

displasia fibromuscular

Colaboradores

Autores

Mauricio Leitao, MD, MBA

Clinical Research Coordinator

University of Massachusetts Chan Medical School

UMass Memorial Medical Center

Worcester

MA

Divulgaciones

ML declares that he has no competing interests.

Alvaro Alonso, MD, MSCR, FSVM

Associate Professor of Medicine

University of Massachusetts Chan Medical School

UMass Memorial Medical Center

Worcester

MA

Divulgaciones

AA declares that he has no competing interests.

Agradecimientos

Dr Alvaro Alonso and Dr Mauricio Leitao would like to gratefully acknowledge Dr Rohit Malhotra, Dr Manmeet Singh and Dr Scott J. Gilbert, previous contributors to this topic. RM, MS and SJG declare that they have no competing interests.

Revisores por pares

Robert Tompkins, MD

Associate Professor

Department of Family Medicine

University of Texas Health Science Center

Tyler

TX

Divulgaciones

RT declares that he has no competing interests.

Irfan Moinuddin, MD

Assistant Professor

Chicago Medical School

Rosalind Franklin University

Lombard

IL

Divulgaciones

IM declares that he has no competing interests.

John Webster, MD

Professor

Aberdeen Royal Infirmary

Foresterhill

Scotland

Divulgaciones

JW declares that he has no competing interests.

Neil A. Kurtzman, MD

Grover E. Murray Professor

University Distinguished Professor

Texas Tech University Medical Center

Lubbock

TX

Divulgaciones

NAK declares that he has no competing interests.

Peer reviewer acknowledgements

BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.

Disclosures

Peer reviewer affiliations and disclosures pertain to the time of the review.

Referencias

Nuestros equipos internos de evidencia y editoriales colaboran con colaboradores expertos internacionales y revisores pares para garantizar que brindemos acceso a la información más clínicamente relevante posible.

Artículos principales

Parikh SA, Shishehbor MH, Gray BH, et al. SCAI expert consensus statement for renal artery stenting appropriate use. Catheter Cardiovasc Interv. 2014 Dec 1;84(7):1163-71.Texto completo  Resumen

Gornik HL, Persu A, Adlam D, et al. First International Consensus on the diagnosis and management of fibromuscular dysplasia. Vasc Med. 2019 Jan 16;24(2):164-89.Texto completo  Resumen

Anderson JL, Halperin JL, Albert NM, et al. Management of patients with peripheral artery disease (compilation of 2005 and 2011 ACCF/AHA guideline recommendations): a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. Circulation. 2013 Apr 2;127(13):1425-43.Texto completo  Resumen

Aboyans V, Ricco JB, Bartelink ME, et al. 2017 ESC guidelines on the diagnosis and treatment of peripheral arterial diseases, in collaboration with the European Society for Vascular Surgery (ESVS). Eur Heart J. 2018 Mar 1;39(9):763-816.Texto completo  Resumen

Artículos de referencia

Una lista completa de las fuentes a las que se hace referencia en este tema está disponible para los usuarios con acceso a todo BMJ Best Practice.
  • Estenose da artéria renal images
  • Diferenciales

    • Hipertensão essencial
    • Lesão renal aguda
    • Dissecção da artéria renal
    Más Diferenciales
  • Guías de práctica clínica

    • ACR appropriateness criteria: renovascular hypertension
    • 2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA Guideline for the prevention, detection, evaluation, and management of high blood pressure in adults: a report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines
    Más Guías de práctica clínica
  • Folhetos informativos para os pacientes

    Pressão alta: o que é?

    Pressão alta: quais tratamentos funcionam?

    Mais Folhetos informativos para os pacientes
  • padlock-lockedConectar-se ou assinar para acessar todo o BMJ Best Practice

O uso deste conteúdo está sujeito ao nosso aviso legal