What is the role of renal artery stenosis in the pathophysiology of azotemia?

Updated: Sep 19, 2018
  • Author: Moro O Salifu, MD, MPH, FACP; Chief Editor: Vecihi Batuman, MD, FASN  more...
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Answer

In bilateral renal artery stenosis, maintenance of adequate intraglomerular pressure for filtration greatly depends on efferent arteriolar vasoconstriction. Azotemia sets in when angiotensin-converting enzyme (ACE) inhibitors or angiotensin II receptor blockers (ARBs) cause efferent arteriolar dilatation, thereby decreasing intraglomerular pressure and filtration. Therefore, ACE inhibitors and ARBs are contraindicated in bilateral renal artery stenosis.


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