{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,31]],"date-time":"2026-10-31T03:38:43Z","timestamp":1793417923069,"version":"4.5.0"},"reference-count":49,"publisher":"Oxford University Press (OUP)","license":[{"start":{"date-parts":[[2026,2,11]],"date-time":"2026-02-11T00:00:00Z","timestamp":1770768000000},"content-version":"am","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Renal artery stenosis due to atherosclerotic renovascular disease (ARVD) is common but under-recognized amongst patients with heart failure and chronic kidney disease (CKD). Whether renal artery stenosis is just a manifestation of widespread atherosclerotic disease or a driver of heart failure symptoms, disease progression, and prognosis is controversial and may depend on distinguishing anatomic from functional renal artery stenosis. Anatomical renal artery stenosis can cause nephron damage due to micro-embolization\/infarction or activation of inflammatory pathway, leading to a decline in estimated glomerular filtration rate (eGFR) and albuminuria. Functionally significant renal artery stenosis will, in addition, alter renal haemodynamics, favouring water and salt retention, and may cause nephron ischaemia. Clinical manifestations of renal artery stenosis include hypertension, a progressive decline in renal function, worsening heart failure, and \u2018flash pulmonary oedema\u2019. Anatomical renal artery stenosis can be identified non-invasively using various methods but confirming functional significance may be difficult, creating uncertainty about which patients are likely to benefit from revascularization. If there is a large decline in eGFR after initiating renin\u2013angiotensin\u2013aldosterone system inhibitors (RAASi), this should raise the suspicion of functionally important renal artery stenosis. However, RAASi are an important first line therapy for both ARVD and heart failure. For patients with ARVD and heart failure, RAASi and other guideline-recommended therapies should be initiated with appropriate monitoring of renal function. Further randomized trials investigating the effects of renal revascularization of functionally significant renal artery stenosis on symptoms, renal function, diuretic efficacy, and prognosis in patients with heart failure are required.<\/jats:p>","DOI":"10.1093\/ejhf\/xuag042","type":"journal-article","created":{"date-parts":[[2026,2,10]],"date-time":"2026-02-10T12:35:03Z","timestamp":1770726903000},"source":"Crossref","is-referenced-by-count":1,"title":["Revascularization of atherosclerotic renal artery stenosis in patients with heart failure"],"prefix":"10.1093","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9370-8176","authenticated-orcid":false,"given":"Darren","family":"Green","sequence":"first","affiliation":[{"name":"Donal O\u2019Donoghue Renal Research Centre, Salford Royal Hospital, Northern Care Alliance NHS Foundation Trust, Stott Lane, Salford , Greater Manchester, M6 8HD ,","place":["UK"]},{"name":"Faculty of Biology, Medicine and Health, University of Manchester , Oxford Road, Manchester, M13 9PL ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John G F","family":"Cleland","sequence":"additional","affiliation":[{"name":"School of Cardiovascular and Metabolic Health, 126 University Place, University of Glasgow , Glasgow, G12 8TA ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pierpaolo","family":"Pellicori","sequence":"additional","affiliation":[{"name":"School of Cardiovascular and Metabolic Health, 126 University Place, University of Glasgow , Glasgow, G12 8TA ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hannah","family":"O\u2019Keeffe","sequence":"additional","affiliation":[{"name":"Donal O\u2019Donoghue Renal Research Centre, Salford Royal Hospital, Northern Care Alliance NHS Foundation Trust, Stott Lane, Salford , Greater Manchester, M6 8HD ,","place":["UK"]},{"name":"Faculty of Biology, Medicine and Health, University of Manchester , Oxford Road, Manchester, M13 9PL ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edward","family":"Lake","sequence":"additional","affiliation":[{"name":"Interventional Radiology, Manchester Royal Infirmary, Manchester Foundation Trust , Oxford Road, Manchester, M13 9WL ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Constantina","family":"Chrysochou","sequence":"additional","affiliation":[{"name":"Donal O\u2019Donoghue Renal Research Centre, Salford Royal Hospital, Northern Care Alliance NHS Foundation Trust, Stott Lane, Salford , Greater Manchester, M6 8HD ,","place":["UK"]},{"name":"Faculty of Biology, Medicine and Health, University of Manchester , Oxford Road, Manchester, M13 9PL ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Heliana Morato","family":"Lins e Mello","sequence":"additional","affiliation":[{"name":"Donal O\u2019Donoghue Renal Research Centre, Salford Royal Hospital, 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