343 Ch 342. Renal Vascular Disease and Hypertensive Nephropathy

Renal vascular disease 涵蓋多種：(1) renal artery stenosis (RAS) — atherosclerotic (ARAS, elderly) vs fibromuscular dysplasia (FMD, young women)；(2) renal vein thrombosis (RVT) — nephrotic syndrome (esp MN), hypercoagulable；(3) thrombotic microangiopathy (TMA) — TTP, HUS, aHUS, malignant HTN, scleroderma renal crisis, drug-induced；(4) atheroembolic disease (cholesterol embolism) — post-arterial procedure；(5) vasculitis — large/medium/small vessel；ARAS：atherosclerotic, bilateral often, CORAL trial 2014 — OMT first-line, stent reserved for refractory；FMD：young women, “string of beads” — balloon angioplasty cure；hypertensive nephropathy = chronic HTN → glomerulosclerosis + arteriolar hyalinosis；BP control (< 130/80, ACE/ARB) is key；malignant HTN (rapid + organ damage + TMA) — emergency IV antihypertensives；scleroderma renal crisis — ACE inhibitor lifesaving; TTP = anti-ADAMTS13 → plasma exchange + caplacizumab; aHUS = complement dysregulation → eculizumab/ravulizumab; APOL1 risk in African ancestry HTN nephropathy。