2017 Volume 87 Issue 6 Pages 151-159
Arteriosclerosis is usually classified into atherosclerosis and arteriosclerosis. Nephrosclerosis and renal artery stenosis are important regarding arteriosclerosis in the kidney. Nephrosclerosis advances because of hypertension and aging. Glomerulosclerosis includes two types of abnormalities that are complete opposites, namely ischemia-related sclerosing lesions and sclerosing lesions with glomerular hypertension. Furthermore, it is therapeutically important to decide which of these is the primary pathological condition. Moreover, 90 % of renal artery stenosis cases are atherosclerotic. Activation of the renin-angiotensin-aldosterone system by hypoperfusion of the stenotic kidneys causes renal contraction and renal fibrosis in the long term. Renal artery stenosis worsens the prognosis because of the occurrence of cardiovascular events.
Arteriosclerosis in chronic kidney disease (CKD) is a promoting/aggravating factor of CKD itself. The progression of arterial wall sclerosis of the aorta is a characteristic finding of CKD. For diagnosing arteriosclerosis, it is common to perform carotid ultrasonography, imaging diagnostic modalities such as computed tomography/magnetic resonance imaging, structure evaluation of the vessels, and vascular function testing of the cardio-ankle vascular index, pulse-wave velocity, and ankle-brachial index. Recently, the relationship between intestinal bacteria and arteriosclerosis has garnered attention. Trimethylamine N-oxide (TMAO) in blood has been reported to promote arteriosclerosis, and TMAO is produced by the metabolism of trimethylamine in the liver, which is a degradation product of dietary choline by intestinal bacteria.
