Studies on diagnosis and treatment of renal artery stenosis

This thesis describes studies on ~onosis and treatment of renal artery stenosis in patients with drug-resistant hypertension. In Chapter 1, the clinical problem of renal artery stenosis is discussed. Renal artery stenosis, a narrowing of the renal artery, is a potential cause of secondary hypertension. For this reason, it is important to di~onose a stenosis, so that treatment can be initiated. Treatment of patients with hypertension and renal artery stenosis may potentially prevent cardiovascular complications and renal insufficiency. The research questions on diagnosis concerned (1) the interobserver agreement of captopril renography for the detection of renal artery stenosis, and (2) the value of clinical characteristics for predicting the probability of stenosis in patients with drug-resistant hypertension. The research questions on treatment concerned (1) the comparison of clinical outcomes after balloon angioplasty versus drug therapy for patients with drug-resistant hypertension and atherosclerotic renal artery stenosis, and (2) the cost-effectiveness of several treatment strategies in this patient group.

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