Optimizing medical therapy is the best approach to management of hypertension and chronic kidney disease, with or without renal artery stenosis (RAS). Renal artery angioplasty and stenting may be considered for patients with RAS and complicated, uncontrolled hypertension. Surgery remains the primary approach for patients with complex lesions of arterial bifurcation or branches, stenoses associated with complex aneurysms, or following PTA failure.