{"id":12822,"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":"2026-10-06T12:50:55","modified_gmt":"2026-10-06T16:50:55","slug":"estenose-da-arteria-renal","status":"publish","type":"glossary-term","link":"https:\/\/www.rigicon.com\/pt-br\/glossary-term\/estenose-da-arteria-renal\/","title":{"rendered":"Estenose da Art\u00e9ria Renal"},"content":{"rendered":"","protected":false},"excerpt":{"rendered":"","protected":false},"featured_media":0,"template":"","glossary-category":[134],"glossary-product":[],"class_list":["post-12822","glossary-term","type-glossary-term","status-publish","hentry","glossary-category-vascular-diseases"],"acf":{"gt-definition":"<p>A estenose da art\u00e9ria renal (EAR) \u00e9 uma condi\u00e7\u00e3o vascular caracterizada pelo estreitamento de uma ou ambas as art\u00e9rias renais, levando \u00e0 redu\u00e7\u00e3o do fluxo sangu\u00edneo para os rins.<sup>1<\/sup> Esse estreitamento pode resultar de duas etiologias principais: a aterosclerose, respons\u00e1vel por aproximadamente 90% dos casos, ou a displasia fibromuscular (DFM), que corresponde a cerca de 10% dos diagn\u00f3sticos.<sup>2<\/sup> A EAR ateroscler\u00f3tica normalmente acomete o ter\u00e7o proximal da art\u00e9ria renal, incluindo a aorta perirrenal e o \u00f3stio, enquanto a DFM geralmente envolve os dois ter\u00e7os distais da art\u00e9ria renal.<sup>3<\/sup> A redu\u00e7\u00e3o da perfus\u00e3o renal ativa o sistema renina-angiotensina-aldosterona (SRAA), o que pode levar a hipertens\u00e3o renovascular, nefropatia isqu\u00eamica e, em casos graves, doen\u00e7a renal cr\u00f4nica.<sup>4<\/sup> A EAR \u00e9 considerada uma das principais causas de hipertens\u00e3o secund\u00e1ria, afetando aproximadamente 1% a 10% dos 50 milh\u00f5es de pessoas com hipertens\u00e3o nos Estados Unidos.<sup>5<\/sup><\/p>","gt-synonyms":"Doen\u00e7a renovascular, Doen\u00e7a vascular renal, Estenose ateroscler\u00f3tica da art\u00e9ria renal (ARAS), Hipertens\u00e3o renovascular (quando causa hipertens\u00e3o), Nefropatia isqu\u00eamica (quando causa dano renal), Doen\u00e7a oclusiva da art\u00e9ria 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>A estenose da art\u00e9ria renal \u00e9 clinicamente relevante em v\u00e1rios contextos, principalmente como causa de hipertens\u00e3o secund\u00e1ria e de disfun\u00e7\u00e3o renal progressiva.<sup>1<\/sup> A apresenta\u00e7\u00e3o cl\u00ednica varia de acordo com a gravidade, a progress\u00e3o e o fato de a estenose ser unilateral ou bilateral.<\/p>\n\n<h3>Crit\u00e9rios de sele\u00e7\u00e3o de pacientes:<\/h3>\n<p>Devem ser avaliados quanto \u00e0 EAR os pacientes com:<\/p>\n<ul>\n    <li>In\u00edcio s\u00fabito ou piora da hipertens\u00e3o, especialmente ap\u00f3s os 55 anos<sup>2<\/sup><\/li>\n    <li>Hipertens\u00e3o resistente (que exige tr\u00eas ou mais medicamentos)<sup>3<\/sup><\/li>\n    <li>Epis\u00f3dios recorrentes de edema pulmonar s\u00fabito (flash) ou insufici\u00eancia card\u00edaca congestiva sem explica\u00e7\u00e3o<sup>4<\/sup><\/li>\n    <li>Insufici\u00eancia renal progressiva sem explica\u00e7\u00e3o<sup>5<\/sup><\/li>\n    <li>Diferen\u00e7a significativa no tamanho dos rins (diferen\u00e7a &gt;1,5 cm)<sup>2<\/sup><\/li>\n    <li>Azotemia sem explica\u00e7\u00e3o ao iniciar inibidores da ECA ou bloqueadores dos receptores da angiotensina<sup>3<\/sup><\/li>\n<\/ul>\n\n<h3>Procedimentos diagn\u00f3sticos:<\/h3>\n<p>O diagn\u00f3stico normalmente envolve uma combina\u00e7\u00e3o de suspeita cl\u00ednica e exames de imagem:<\/p>\n<ul>\n    <li>Ultrassonografia Doppler duplex: ferramenta inicial de triagem n\u00e3o invasiva, com sensibilidade vari\u00e1vel (60-90%)<sup>4<\/sup><\/li>\n    <li>Angiotomografia computadorizada (ATC): oferece excelente detalhamento anat\u00f4mico, mas exige contraste iodado<sup>5<\/sup><\/li>\n    <li>Angiorresson\u00e2ncia magn\u00e9tica (ARM): proporciona boa visualiza\u00e7\u00e3o sem contraste iodado, mas pode ser contraindicada em pacientes com comprometimento renal grave<sup>4<\/sup><\/li>\n    <li>Arteriografia renal: padr\u00e3o-ouro para o diagn\u00f3stico, por\u00e9m invasiva e associada ao risco de nefropatia induzida por contraste<sup>5<\/sup><\/li>\n<\/ul>\n\n<h3>Abordagens de tratamento:<\/h3>\n<p>As estrat\u00e9gias de manejo incluem:<\/p>\n<ul>\n    <li>Terapia medicamentosa: anti-hipertensivos (particularmente inibidores da ECA e BRAs na doen\u00e7a unilateral), estatinas, antiagregantes plaquet\u00e1rios e modifica\u00e7\u00e3o dos fatores de risco<sup>2,4<\/sup><\/li>\n    <li>Revasculariza\u00e7\u00e3o: angioplastia renal transluminal percut\u00e2nea com implante de stent para pacientes selecionados com estenose grave e hemodinamicamente significativa, especialmente aqueles com edema pulmonar s\u00fabito recorrente, disfun\u00e7\u00e3o renal progressiva ou hipertens\u00e3o resistente<sup>3,5<\/sup><\/li>\n    <li>Revasculariza\u00e7\u00e3o cir\u00fargica: reservada para casos complexos n\u00e3o adequados a abordagens endovasculares<sup>4<\/sup><\/li>\n<\/ul>\n\n<h3>Resultados esperados:<\/h3>\n<p>Os resultados variam de acordo com a sele\u00e7\u00e3o dos pacientes e o momento da interven\u00e7\u00e3o:<\/p>\n<ul>\n    <li>Foi relatada melhora da press\u00e3o arterial ap\u00f3s a revasculariza\u00e7\u00e3o em s\u00e9ries observacionais de pacientes selecionados, embora ensaios randomizados (ASTRAL, CORAL) tenham mostrado pouco ou nenhum benef\u00edcio adicional em rela\u00e7\u00e3o \u00e0 terapia medicamentosa otimizada<sup>2<\/sup><\/li>\n    <li>A estabiliza\u00e7\u00e3o ou melhora da fun\u00e7\u00e3o renal \u00e9 relatada em uma minoria dos pacientes<sup>5<\/sup><\/li>\n    <li>A redu\u00e7\u00e3o de eventos cardiovasculares e o benef\u00edcio na sobrevida continuam controversos e dependem da sele\u00e7\u00e3o adequada dos pacientes<sup>3,4<\/sup><\/li>\n<\/ul>\n\n<p>O ensaio Cardiovascular Outcomes in Renal Atherosclerotic Lesions (CORAL) demonstrou que a maioria dos pacientes com EAR ateroscler\u00f3tica pode ser tratada apenas com terapia medicamentosa otimizada, reservando-se a revasculariza\u00e7\u00e3o para subgrupos espec\u00edficos de alto risco.<sup>3,5<\/sup><\/p>","gt-related-evidence":null,"gt-featured":true,"gt-ai-referenced":false,"gt-view-count":122},"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>Estenose da Art\u00e9ria Renal: Hipertens\u00e3o Renovascular | Rigicon<\/title>\n<meta name=\"description\" content=\"Conhe\u00e7a a estenose da art\u00e9ria renal: causa de hipertens\u00e3o renovascular e insufici\u00eancia renal. 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