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<p>This article highlights the latest updates and changes to the S2k guideline on renal artery diseases. This guideline was developed under the leadership of the German Society for Vascular Surgery and Vascular Medicine (DGG) through a&#xa0;consensus-based, interdisciplinary process. The goal of this update was to integrate new findings and to focus on patient groups who genuinely benefit from invasive treatment of atherosclerotic renal artery stenosis (RAS). In contrast to previous, mostly negative, randomized studies that led to a&#xa0;decline in invasive procedures, the revised guideline emphasizes that a&#xa0;specifically selected patient group can still benefit from intervention. Key new features include the removal of certain diagnostic recommendations due to insufficient evidence or lack of consensus. A&#xa0;central update is the upgrading of the recommendation for percutaneous revascularization in high-grade RAS when it is accompanied by a&#xa0;combination of therapy-resistant hypertension and rapidly deteriorating renal function. This change is supported by recent subgroup analyses and publications demonstrating clear benefits in specific high-risk patients. Even in dialysis patients with high-grade RAS, revascularization may be considered within the first 3&#xa0;months after starting dialysis to potentially avoid the need for dialysis. Furthermore, new recommendations have been added regarding follow-up care, including clinical and duplex sonographic controls, as well as the requirement that interventions should only be performed in facilities with sufficient expertise and comprehensive complication management. Finally, the guideline defines “unmet needs” and clear inclusion criteria for future randomized studies to further optimize patient selection for invasive therapies. The guideline focuses exclusively on arteriosclerotic stenoses in adults.</p>

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Update Leitlinie arteriosklerotische Nierenarterienstenose

  • 期刊论文

  • 发表日期：

    2025年9月4日

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  • A. Oberhuber,
  • O. Vonend,
  • J. Radermacher,
  • K. Stock,
  • G. M. Richter,
  • W. Ito,
  • E. Blessing,
  • E. Stegemann,
  • B. Krabbe,
  • M. Weckesser,
  • T. Zeller,
  • F. Mahfoud,
  • K. Balzer

摘要

This article highlights the latest updates and changes to the S2k guideline on renal artery diseases. This guideline was developed under the leadership of the German Society for Vascular Surgery and Vascular Medicine (DGG) through a consensus-based, interdisciplinary process. The goal of this update was to integrate new findings and to focus on patient groups who genuinely benefit from invasive treatment of atherosclerotic renal artery stenosis (RAS). In contrast to previous, mostly negative, randomized studies that led to a decline in invasive procedures, the revised guideline emphasizes that a specifically selected patient group can still benefit from intervention. Key new features include the removal of certain diagnostic recommendations due to insufficient evidence or lack of consensus. A central update is the upgrading of the recommendation for percutaneous revascularization in high-grade RAS when it is accompanied by a combination of therapy-resistant hypertension and rapidly deteriorating renal function. This change is supported by recent subgroup analyses and publications demonstrating clear benefits in specific high-risk patients. Even in dialysis patients with high-grade RAS, revascularization may be considered within the first 3 months after starting dialysis to potentially avoid the need for dialysis. Furthermore, new recommendations have been added regarding follow-up care, including clinical and duplex sonographic controls, as well as the requirement that interventions should only be performed in facilities with sufficient expertise and comprehensive complication management. Finally, the guideline defines “unmet needs” and clear inclusion criteria for future randomized studies to further optimize patient selection for invasive therapies. The guideline focuses exclusively on arteriosclerotic stenoses in adults.