Renal artery stenosis of solitary kidney: The dilemma

Background. Renal artery stenosis is an important cause of hypertension and renal failure. When present in a solitary kidney, it is associated with extremely high morbidity and mortality. Although guidelines suggest an aggressive approach by revascularization in these cases, available evidence is too weak and contradictory to provide definite recommendations for treatment. Objectives. To discuss the various clinical factors predicting the benefit from revascularization. Methods and Results. Review of more recent clinical trials is presented. Discussion. The approach to the patient with single kidney and renal artery stenosis is discussed and, although there is insufficient evidence-based medicine for guidelines, some suggestions are made to predict revascularization results in these cases. Conclusion. Continuous development of clinical prediction rules will help in the management of renal artery stenosis of solitary kidney.