Description of the disease (time of onset, main symptoms, hospital visited, etc.): Eight years of history of diabetes mellitus, which has been unmedicated and controlled by diet (smoking and alcohol have not been cut off). Two months ago, diabetes mellitus was found to be complicated by arteriosclerosis of both lower limbs and renal artery stenosis. Half a month ago, he had an MRI examination in the hospital. In the past half month, he was treated with medication (blood vessel expansion and blood sugar reduction) at the county hospital at home. I am not sure if it is possible to do conservative treatment instead of stenting for renal artery stenosis. Response: Whether the renal artery stenosis is treated surgically or not depends on two main aspects. Whether surgery is needed depends mainly on whether the hypertension is poorly controlled by medication. If the problem of blood pressure can be well controlled by taking one or two drugs orally, then conservative treatment can be considered. If the blood pressure is not well controlled and the renal artery stenosis lesion is clear, early treatment is recommended. American studies show that about 15% of patients with renal artery stenosis develop uremia each year and require dialysis treatment. The possibility of surgery depends mainly on the kidney function. The first is the type and location of renal artery stenosis, the distal renal artery with extensive stenosis is not suitable for surgery; the second is the presence of atrophy of the affected kidney, renogram nuclear imaging to check whether the glomerular filtration rate has failed, if the single kidney function is significantly failed surgery is not very meaningful; the third is to look at the renal function, the possibility of postoperative contrast nephropathy leading to uremia increases dramatically in patients with too poor renal function, also not suitable for surgery. In short, there is no evidence to prove that drug therapy must be better than stent or stent must be better than drug therapy. How to choose depends on the comprehensive judgment of your condition. Smoking must be quit, otherwise the lesion may deteriorate rapidly.