Renal artery diameter: a “new” parameter beyond an old disease - the renal artery stenosis

Recently, taking advantage of the cohort of the RAS-CAD (Renal Artery Stenosis in Coronary ArteryDisease) Study (NCT 01173666), a large randomized controlled trial designed to determine whether thestenting of the renal artery is of benefit in reducing the left ventricular mass, our group reported that smallrenal arteries, for the first time defined by a low reference diameter or minimal luminal diameter, (a) areassociated with low GFR and resistant hypertension independently of the degree of stenosis and majorconfounders, (b) predict the development of contrast-induced nephropathy better than the unspecificbaseline reduction of GFR independently of major confounders and (c) could impact the prognosis ofpatients with ischemic heart disease and non-significant renal artery stenosis (10-70%) independently ofmajor confounders. These results are clinically relevant and suggest that the renal artery diameter couldrepresents a marker of non-traditional cardiovascular risk factors in selected populations. In the presentchapter, these results will be presented, and a pathophysiological explanation, including main biophysicalbackground, and the clinical implication of these new findings will be critically discussed.