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Durchblutungsstörungen der Nieren- und Mesenterialarterien

Circulatory disorders of the renal and mesenteric arteries

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Zusammenfassung

Symptomatische mesenteriale Durchblutungsstörungen sind ein potenziell lebensbedrohliches Krankheitsbild mit aufgrund der demographischen Bevölkerungsentwicklung zunehmender Häufigkeit. Nierenarterienstenosen sind Ursache einer arteriellen Hypertonie oder deren verschlechterter Einstellbarkeit sowie bei arteriosklerotischer Genese einer zum Teil progredienten Niereninsuffizienz. Weitere Folgen wie linksventrikuläre Myokardhypertrophie und hypertensive Enzephalopathie sind Gegenstand neuerer Forschung. Fortschritte in der Kathetertechnologie haben in den letzten 10 Jahren die Gefäßchirurgie als Methode der Wahl zur Revaskularisation der meist ostialen arteriosklerotischen Stenosen abgelöst. Die einzige randomisierte Studie (ASTRAL) konnte bisher den Nutzen der Stentrevaskularisation von Nierenarterienstenosen gegenüber der konservativen Therapie nicht belegen.

Abstract

Symptomatic mesenteric circulatory disorders are potentially life- threatening diseases with an increasing frequency due to the demographic population development. Renal artery stenosis is a well accepted cause of hypertension or at least deterioration of blood pressure control as well as the cause of a progressive course of renal insufficiency if of an atherosclerotic nature. Further consequences of renal artery stenosis, such as left ventricle hypertrophy and hypertensive encephalopathy are topics of recent research. Due to progress in percutaneous techniques during the last decade interventional therapy has replaced surgery as the treatment method of choice for lesions located near the origin. The only randomized study comparing endovascular stent revascularization with best medical therapy (ASTRAL) failed to show a benefit of revascularization of renal artery stenoses.

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Interessenkonflikt

Der korrespondierende Autor weist auf folgende Beziehungen hin:

Kooperation im Rahmen von Studien mit BARD, Pathway Medical, Invatec, Cook, Cordis, Abbott Vascular, ev3, Biotronic, Angioslide. Es besteht jedoch kein Zusammenhang zwischen Firmeninteressen und dem vorliegenden Artikel.

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Authors and Affiliations

  1. Klinik für Nieren-, Hochdruck- und Gefäßerkrankungen, Klinikum Oststadt- Heidehaus, Klinikum Region Hannover GmbH, Hannover, Deutschland

    R. Brunkhorst & H.P. Lorenzen

  2. Abteilung Angiologie, Herz-Zentrum Bad Krozingen, Südring 15, 79189, Bad Krozingen, Deutschland

    T. Zeller

Authors
  1. R. Brunkhorst
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  2. H.P. Lorenzen
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  3. T. Zeller
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Correspondence to T. Zeller.

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Brunkhorst, R., Lorenzen, H. & Zeller, T. Durchblutungsstörungen der Nieren- und Mesenterialarterien. Internist 50, 952–957 (2009). https://doi.org/10.1007/s00108-009-2368-0

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