Renal artery atherosclerosis
ICD-10 N28.0 · ICD-11 BD40.2

Treatment of Renal Artery Atherosclerosis in New Dialysis Patients (<3 Months) with a Nonfunctioning but Possibly Viable Kidney

Clinical Scenario

This protocol applies to patients who have recently started dialysis — within the first three months — and who have renal artery atherosclerosis alongside a kidney that is currently nonfunctioning but may still retain viability.

Identifying this subgroup is clinically significant: a nonfunctioning kidney is not necessarily a permanently lost kidney, and the duration of dialysis is a key consideration when evaluating the potential for recovery.

Key Condition Features

The defining feature of this scenario is a new dialysis patient (less than 3 months on renal replacement therapy) who presents with a nonfunctioning but possibly viable kidney in the context of renal artery atherosclerosis.

The possibility of kidney viability — sometimes described as a "hibernated" state — is the central clinical question that drives the treatment approach in this situation.

Treatment Direction (Partial Overview)

When a nonfunctioning kidney is identified as potentially still viable, a revascularization-based approach targeting the severely stenosed renal artery is a consideration for attempting to recover kidney function.

The complete structured protocol — including full eligibility criteria, procedural details, and the complete clinical algorithm — is available via the link below.

Instant Access to Structured Evidence-Based Regimens

References

DOI: 10.1053/j.ajkd.2021.06.025

New (<3 mo) dialysis patient with nonfunctioning but possibly viable kidney.

However, occasional patients may have nonfunctioning but still viable (ie, "hibernated") kidneys that may recover function after revascularization and/or regenerative therapies.

Currently, dialysis patients with reversible kidney damage related to severe ARVD who may benefit from revascularization are often denied this possibility because of our inability to identify them and also because of the decrease in use of renal revascularization procedures following the results of the RCTs.

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