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Die Nephrologie

Erschienen in:

21.11.2023 | Nierenarterienstenose | CME

Nierenarterienstenose

verfasst von: Prof. Dr. med. Jörg Radermacher

Erschienen in: Die Nephrologie | Ausgabe 1/2024

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Zusammenfassung

Patienten sollten nur dann auf das Bestehen einer Nierenarterienstenose gescreent werden, wenn sie eine erhöhte Wahrscheinlichkeit für das Bestehen einer Stenose und relevante klinische Probleme aufweisen. Gute Screeningmethoden sind Farbdoppler, Angio-CT (Computertomographie) und Magnetresonanztomographie. Alle Methoden sind untersucherabhängig, und der Sonographie wird aufgrund der geringeren Nebenwirkungen und Kosten in den Leitlinien der Vorzug gegeben. Die Korrektur einer Nierenarterienstenose sollte nicht allein vom Stenosegrad abhängig gemacht werden, da eine Vielzahl von randomisierten Studien zum Vergleich von Angioplastie mit optimaler medikamentöser Therapie keine Überlegenheit zeigen konnte. Geeignete Kandidaten für eine Angioplastie sind aber Patienten mit einem Stenosegrad von 60 % oder mehr und schlecht eingestelltem Blutdruck und sich verschlechternder Nierenfunktion sowie Patienten mit plötzlichem Lungenödem oder wiederholter akuter Herzinsuffizienz. Alle Patienten sollten eine Blutdruckeinstellung mit einem RAAS(Renin-Angiotensin-Aldosteron-System)-Inhibitor, eine Statin- und eine plättchenhemmende Therapie erfahren, Nikotinverzicht und körperliche Aktivität üben und sich gesund ernähren.

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Titel: Nierenarterienstenose
verfasst von: Prof. Dr. med. Jörg Radermacher
Publikationsdatum: 21.11.2023
Verlag: Springer Medizin
Schlagwörter: Nierenarterienstenose
Nierenarterienstenose
Hypertonie
Arteriosklerose
Erschienen in: Die Nephrologie / Ausgabe 1/2024
Print ISSN: 2731-7463
Elektronische ISSN: 2731-7471
DOI: https://doi.org/10.1007/s11560-023-00692-0

Springer Medizin

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