Mechanisms of Nephropathy Caused by ARAS and Optimal Treatments
The prevalence of atherosclerotic renal artery stenosis (ARAS) is on the rise globally in the aging society, and it has become a common etiology of renovascular hypertension and chronic kidney disease, which will eventually develop into end-stage renal disease.
However, outcomes after renal revascularization procedures are disappointing compared with those with renal artery stenosis alone, as nearly half fail to achieve renal function improvement. This has spurred the need for the study of mechanisms of nephropathy caused by ARAS and for the development of optimal treatment strategies.
In this research project, Mechanisms of Nephropathy Caused by ARAS and Optimal Treatments, Dr. Lerman's Renovascular Disease Lab is:
- Exploring the pathophysiological mechanism of kidney injury due to RAS and detrimental atherosclerotic risk factors (such as hypercholesterolemia and hypertension)
- Seeking predictive factors associated with renal recovery after percutaneous transluminal renal angioplasty (PTRA)
- Discovering novel strategies to enhance renal vascular repair and improve renal outcome after PTRA
One research interest is in the renal effect of low-energy shock wave therapy in renal artery stenosis. This ongoing project is based on the ability of shock wave therapy to increase microvascular density in the ischemic myocardium, which is also being applied in the ischemic kidney.
By using unique imaging techniques, adaptive intrarenal physiological and structural responses to shock wave therapy are accessed and evaluated in a RAS swine model.
Another project in the Renovascular Disease Lab centers on the role of peristenotic and perirenal collateral circulation in preserving the structure and function of the post-stenotic kidneys.
The lab is studying the effects of cardiovascular risk factors on collateral formation in pig models and in human research participants with atherosclerotic renal artery stenosis. Dr. Lerman's research team is also developing new methods to assess the collateral circulation using computerized tomography.
For more information about the Renovascular Disease Lab's research project on mechanisms of nephropathy caused by ARAS, email Xin Zhang, M.D.