Renovascular Disease - Lilach O. Lerman

Xin Zhang, M.D.

The prevalence of atherosclerotic renal artery stenosis (ARAS) is on the rise globally in the aging society and has become a common etiology of renovascular hypertension and chronic kidney disease which will eventually develope to ESRD(End Stage Renal Disease). However, the outcomes after renal revascularization are disappointing compared to RAS alone as nearly half fails to achieve renal function improvement. This has urged the need for the study of mechanisms of nephropathy caused by ARAS and the exploit of the optimal treatment.

Our team is devoted to explore the pathophysiologic mechanism of kidney injuries due to renal artery stenosis and atherosclerotic detrimental factors (e.g. Hypercholesterolemia), seek predictive factors associated with renal recovery after PTRA(S), and discover novel strategies to enhance the renal vascular repair and improve renal outcome after PTRA(S).

One of my research interests is in the renal effect of Angiotensin Receptor Blockade-Valsartan in renal artery stenosis. This ongoing project is based on the controversy and uncertainty of whether Angiotensin-converting-enzyme-inhibitor/Angiotensin Receptor Blockade would protect or aggravate renal ischemia under the condition of renal hypoperfusion induced by renal artery stenosis. By adopting unique imaging techniques, intra-renal physiological and structural changes are accessed and evaluated in a RAS swine model.

Another project I am dedicated to is on the effect of Humanin on kidney insults caused by atherosclerosis. Humanin is an anti-apoptotic factor rescuing neuronal cells from apoptosis in Alzheimer's disease. In this project, by using a murine model, its potential role in the mechanisms of kidney damages induced by atherosclerosis including apoptosis, inflammation and angiogenesis etc is examined through kidney morphology, histology and biochemical analysis.