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Atherosclerotic renal artery stenosis — ABIM Board MCQ

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HardNephrologyAtherosclerotic renal artery stenosisABIM Board

A 66-year-old man has recurrent flash pulmonary edema and resistant hypertension. Creatinine rises from 1.1 to 1.8 mg/dL after starting lisinopril. Abdominal bruit is present. Duplex ultrasound suggests bilateral renal artery stenosis. Which of the following is the most appropriate management?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: E — Renal artery revascularization evaluation

Most atherosclerotic renal artery stenosis is treated medically, but recurrent flash pulmonary edema, refractory hypertension, or marked renal function decline with renin-angiotensin blockade are clinical scenarios in which revascularization evaluation is appropriate.

Reference: AHA Scientific Statement on Renovascular Disease; KDIGO CKD Guidance