Prise en charge des sténoses athéromateuses des artères rénales, en particulier chez le patient diabétique : où en sommes-nous en 2010 ?

Atherosclerotic renovascular disease is encountered in 15-25% of diabetic patients with hypertension. Renal artery stenosis per se confers an excess of cardiovascular risk. Renal artery stenosis (RAS) is associated with chronic kidney disease and hypertension although the relationship between stenosis and these two conditions remains unclear. Uncontrolled or refractory hypertension, unexplained rapid decline of renal function, suggest the diagnosis. Renal ultrasonography and renal-artery imaging are reviewed. Medical therapy of the cardiovascular risk is needed. The clinical benefit of revascularization is still controversial. Two recent studies, ASTRAL and STAR are discussed in this paper.