{"id":12197,"date":"2025-08-05T09:52:48","date_gmt":"2025-08-05T13:52:48","guid":{"rendered":"https:\/\/www.rigicon.com\/glossary-term\/renal-artery-stenosis\/"},"modified":"2026-10-06T18:04:24","modified_gmt":"2026-10-06T22:04:24","slug":"estenosis-de-la-arteria-renal","status":"publish","type":"glossary-term","link":"https:\/\/www.rigicon.com\/es\/glossary-term\/estenosis-de-la-arteria-renal\/","title":{"rendered":"Estenosis de la Arteria Renal"},"content":{"rendered":"","protected":false},"excerpt":{"rendered":"","protected":false},"featured_media":0,"template":"","glossary-category":[134],"glossary-product":[],"class_list":["post-12197","glossary-term","type-glossary-term","status-publish","hentry","glossary-category-vascular-diseases"],"acf":{"gt-definition":"<p>La estenosis de la arteria renal (EAR) es una afecci\u00f3n vascular caracterizada por el estrechamiento de una o ambas arterias renales, lo que reduce el flujo sangu\u00edneo hacia los ri\u00f1ones.<sup>1<\/sup> Este estrechamiento puede deberse a dos etiolog\u00edas principales: la aterosclerosis, responsable de aproximadamente el 90% de los casos, o la displasia fibromuscular (DFM), que representa alrededor del 10% de los diagn\u00f3sticos.<sup>2<\/sup> La EAR ateroscler\u00f3tica suele afectar al tercio proximal de la arteria renal, incluidos la aorta perirrenal y el ostium, mientras que la DFM suele afectar a los dos tercios distales de la arteria renal.<sup>3<\/sup> La disminuci\u00f3n de la perfusi\u00f3n renal activa el sistema renina-angiotensina-aldosterona (SRAA), lo que puede provocar hipertensi\u00f3n renovascular, nefropat\u00eda isqu\u00e9mica y, en los casos graves, enfermedad renal cr\u00f3nica.<sup>4<\/sup> La EAR se considera una causa importante de hipertensi\u00f3n secundaria y afecta aproximadamente al 1% a 10% de los 50 millones de personas con hipertensi\u00f3n en Estados Unidos.<sup>5<\/sup><\/p>","gt-synonyms":"enfermedad renovascular, Enfermedad vascular renal, Estenosis ateroscler\u00f3tica de la arteria renal (ARAS), Hipertensi\u00f3n renovascular (cuando causa hipertensi\u00f3n), Nefropat\u00eda isqu\u00e9mica (cuando causa da\u00f1o renal), Enfermedad oclusiva de la arteria renal","gt-citation":"[1] Silva J, Tonheiro J, Rodrigues F. The \"Silent Enemy\" Called Renal Artery Stenosis: A Mini-Review. J Vasc Dis. 2025;4(1):10. DOI: https:\/\/doi.org\/10.3390\/jvd4010010\n\n[2] Dobrek L. An Outline of Renal Artery Stenosis Pathophysiology\u2014A Narrative Review. Life. 2021;11(3):208. DOI: https:\/\/doi.org\/10.3390\/life11030208\n\n[3] Weber BR, Dieter RS. Renal artery stenosis: epidemiology and treatment. Int J Nephrol Renovasc Dis. 2014;7:169-181. DOI: https:\/\/doi.org\/10.2147\/IJNRD.S40175\n\n[4] Rout P, Rauf N, Bokhari SRA. Renal Artery Stenosis. StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2026. PMID: 28613469. https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK430718\/\n\n[5] Sarafidis PA, Theodorakopoulou M, Ortiz A, et al. Atherosclerotic renovascular disease: a clinical practice document by the European Renal Best Practice (ERBP) board of the European Renal Association (ERA) and the Working Group Hypertension and the Kidney of the European Society of Hypertension (ESH). Nephrol Dial Transplant. 2023;38(12):2835-2850. DOI: https:\/\/doi.org\/10.1093\/ndt\/gfad095. PMID: 37202218","gt-clinical-context":"<p>La estenosis de la arteria renal es cl\u00ednicamente relevante en varios contextos, principalmente como causa de hipertensi\u00f3n secundaria y de disfunci\u00f3n renal progresiva.<sup>1<\/sup> La presentaci\u00f3n cl\u00ednica var\u00eda seg\u00fan la gravedad, la progresi\u00f3n y el car\u00e1cter unilateral o bilateral de la estenosis.<\/p>\n\n<h3>Criterios de selecci\u00f3n de pacientes:<\/h3>\n<p>Deben evaluarse para descartar EAR los pacientes con:<\/p>\n<ul>\n    <li>Hipertensi\u00f3n de inicio s\u00fabito o que empeora, sobre todo despu\u00e9s de los 55 a\u00f1os<sup>2<\/sup><\/li>\n    <li>Hipertensi\u00f3n resistente (que requiere tres o m\u00e1s f\u00e1rmacos)<sup>3<\/sup><\/li>\n    <li>Episodios recurrentes de edema pulmonar s\u00fabito (flash) o insuficiencia card\u00edaca congestiva de causa no aclarada<sup>4<\/sup><\/li>\n    <li>Insuficiencia renal progresiva de causa no aclarada<sup>5<\/sup><\/li>\n    <li>Diferencia significativa en el tama\u00f1o de los ri\u00f1ones (diferencia &gt;1,5 cm)<sup>2<\/sup><\/li>\n    <li>Azoemia de causa no aclarada al iniciar inhibidores de la ECA o antagonistas de los receptores de angiotensina<sup>3<\/sup><\/li>\n<\/ul>\n\n<h3>Procedimientos diagn\u00f3sticos:<\/h3>\n<p>El diagn\u00f3stico suele basarse en una combinaci\u00f3n de sospecha cl\u00ednica y pruebas de imagen:<\/p>\n<ul>\n    <li>Ecograf\u00eda d\u00faplex Doppler: herramienta inicial de cribado no invasiva con sensibilidad variable (60-90%)<sup>4<\/sup><\/li>\n    <li>Angiograf\u00eda por tomograf\u00eda computarizada (angio-TC): ofrece un excelente detalle anat\u00f3mico, pero requiere contraste yodado<sup>5<\/sup><\/li>\n    <li>Angiograf\u00eda por resonancia magn\u00e9tica (angio-RM): proporciona una buena visualizaci\u00f3n sin contraste yodado, pero puede estar contraindicada en pacientes con insuficiencia renal grave<sup>4<\/sup><\/li>\n    <li>Arteriograf\u00eda renal: el m\u00e9todo de referencia para el diagn\u00f3stico, pero es invasiva y conlleva riesgo de nefropat\u00eda por contraste<sup>5<\/sup><\/li>\n<\/ul>\n\n<h3>Enfoques terap\u00e9uticos:<\/h3>\n<p>Las estrategias de manejo incluyen:<\/p>\n<ul>\n    <li>Tratamiento m\u00e9dico: antihipertensivos (sobre todo inhibidores de la ECA y ARA-II en la enfermedad unilateral), estatinas, antiagregantes plaquetarios y modificaci\u00f3n de los factores de riesgo<sup>2,4<\/sup><\/li>\n    <li>Revascularizaci\u00f3n: angioplastia renal transluminal percut\u00e1nea con colocaci\u00f3n de stent en pacientes seleccionados con estenosis grave y hemodin\u00e1micamente significativa, especialmente en aquellos con edema pulmonar s\u00fabito recurrente, disfunci\u00f3n renal progresiva o hipertensi\u00f3n resistente<sup>3,5<\/sup><\/li>\n    <li>Revascularizaci\u00f3n quir\u00fargica: reservada para casos complejos no aptos para abordajes endovasculares<sup>4<\/sup><\/li>\n<\/ul>\n\n<h3>Resultados esperados:<\/h3>\n<p>Los resultados var\u00edan en funci\u00f3n de la selecci\u00f3n de pacientes y del momento de la intervenci\u00f3n:<\/p>\n<ul>\n    <li>Se ha descrito una mejor\u00eda de la presi\u00f3n arterial tras la revascularizaci\u00f3n en series observacionales de pacientes seleccionados, aunque los ensayos aleatorizados (ASTRAL, CORAL) mostraron un beneficio adicional escaso o nulo frente al tratamiento m\u00e9dico \u00f3ptimo<sup>2<\/sup><\/li>\n    <li>Se describe estabilizaci\u00f3n o mejor\u00eda de la funci\u00f3n renal en una minor\u00eda de pacientes<sup>5<\/sup><\/li>\n    <li>La reducci\u00f3n de eventos cardiovasculares y el beneficio en la supervivencia siguen siendo controvertidos y dependen de una selecci\u00f3n adecuada de los pacientes<sup>3,4<\/sup><\/li>\n<\/ul>\n\n<p>El ensayo Cardiovascular Outcomes in Renal Atherosclerotic Lesions (CORAL) demostr\u00f3 que la mayor\u00eda de los pacientes con EAR ateroscler\u00f3tica pueden tratarse solo con tratamiento m\u00e9dico \u00f3ptimo, reservando la revascularizaci\u00f3n para subgrupos espec\u00edficos de alto riesgo.<sup>3,5<\/sup><\/p>","gt-related-evidence":null,"gt-featured":true,"gt-ai-referenced":false,"gt-view-count":86},"yoast_head":"<!-- This site is optimized with the Yoast SEO Premium plugin v28.7 (Yoast SEO v28.7) - https:\/\/yoast.com\/product\/yoast-seo-premium-wordpress\/ -->\n<title>Estenosis de la Arteria Renal<\/title>\n<meta name=\"description\" content=\"La estenosis de la arteria renal es el estrechamiento de los vasos que irrigan el ri\u00f1\u00f3n, causa frecuente de hipertensi\u00f3n arterial y disfunci\u00f3n renal.\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/www.rigicon.com\/es\/glossary-term\/estenosis-de-la-arteria-renal\/\" \/>\n<meta property=\"og:locale\" content=\"es_ES\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" 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