Abstract
Background
Renal artery stenosis is a potential cause of secondary hypertension, ischemic nephropathy and end-stage renal disease. Atherosclerosis is by far the most common etiology of renal artery stenosis in elderly. We investigated whether the presence of significant atherosclerotic renal artery stenosis (ARAS) with luminal diameter narrowing ≥50 % could be predicted in patients undergoing peripheral and coronary angiography.
Methods
The records of 3,500 consecutive patients undergoing simultaneous renal angiography along with peripheral and coronary angiography were reviewed. The patients with known renal artery disease were excluded.
Results
Prevalence of ARAS was 5.7 %. Significant ARAS (luminal diameter narrowing ≥50 %) was present in 139 patients (3.9 %). Hypertension with altered serum creatinine and triple-vessel CAD were associated with significant renal artery stenosis in multivariate analysis. No significant relationship between the involved coronary arteries like left anterior descending, left circumflex, right coronary artery and ARAS was found. Only hypertension and altered serum creatinine were associated with bilateral ARAS. Extent of CAD or risk factors like diabetes, hyperlipidemia or smoking did not predict the unilateral or bilateral ARAS.
Conclusion
Prevalence of ARAS among the patients in routine cardiac catheterization was 5.7 %. Hypertension is closely associated with significant ARAS. Significant CAD in the form of triple-vessel disease and altered renal function tests are closely associated with ARAS. They predict the presence of significant renal artery stenosis in patients undergoing routine peripheral and coronary angiography. Moreover, hypertension and altered renal functions predict bilateral ARAS.
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References
Zeller Thomas (2005) Renal artery stenosis: epidemiology, clinical manifestation and percutaneous endovascular therapy. J Interven Cardiol 18:497–506
Gonçalves JA, Amorim JE, Soares Neto MM, Ribeiro AB, Lima VC (2007) Clinical efficacy of percutaneous renal revascularization with stent placement in atherosclerotic renovascular disease. Arq Bras Cardiol 88(1):85–90
Conlon PJ, Little MA, Pieper K et al (2001) Severity of renal vascular disease predicts mortality in patients undergoing coronary angiography. Kidney Int J 60:1490–1497
Wang Y, Ho DS, Chen WH et al (2003) Prevalence and predictors of renal artery stenosis in Chinese patients with coronary artery disease. Intern Med J 33:280–285
Weber-Mzell D, Kotanko P, Schumacher M et al (2002) Coronary anatomy predicts presence or absence of renal artery stenosis. A prospective study in patients undergoing cardiac catheterization for suspected coronary artery disease. Eur Heart J 23:1684–1691
Leertouwer TC, Pattynama PMT, Van Den Berg-Huysmans A (2001) Incidental renal artery stenosis in peripheral vascular disease: a case for treatment? Kidney Int 59:1480–1483
Ollivier R, Boulmier D, Veillard D et al (2009) Frequency and predictors of renal artery stenosis in patients with coronary artery disease. Cardiovasc Revasc Med J 10:23–29
Buller CE, Nogareda JG, Ramanathan K et al (2004) The profile of cardiac patients with renal artery stenosis. Am Coll Cardiol J 43:1606–1613
Rihal CS, Textor SC, Breen JF et al (2002) Incidental renal artery stenosis among a prospective cohort of hypertensive patients undergoing coronary angiography. Mayo Clin Proc J 77:309–316
Rokni N, Salarifar M, Hakki Kazazi E et al (2012) Frequency and predictors of renal artery stenosis in patients undergoing simultaneous coronary and renal catheterization. J Tehran Heart Cent (Iran) 7(2):58–64
Bageacu S, Cerisier A, Isaaz K, Nourissat A, Barral X, Favre JP (2011) Incidental visceral and renal artery stenosis in patients undergoing coronary angiography. Eur J Vasc Endovasc Surg 41:385–390
Olechnowicz-Tietz S, Gluba A, Paradowska A, Banach M, Rysz J (2013) The risk of atherosclerosis in patients with chronic kidney disease. Int Urol Nephrol. doi:10.1007/s11255-013-0407-1
Jean WJ, Al-Bitar I, Zwicke DL, Port SC, Schmidt DH, Bajwa TK (1994) High incidence of renal artery stenosis in patients with coronary artery disease. Cathet Cardiovasc Diagn 32:8–10
Uzu T, Inoue T, Fujii T, Nakamura S, Inenaga T, Yutani C, Kimura G (1997) Prevalence and predictors of renal artery stenosis in patients with myocardial infarction. Am J Kidney Dis 29:733–738
Yamashita Takehiro, Ito Fumihiro, Iwakiri Naoki, Mitsuyama Hirofumi, Fujii Satoshi, Kitababatake Akira (2002) Prevalence and predictors of renal artery stenosis in patients undergoing cardiac catheterization. Hypertens Res 25:553–557
Van Jaarsveld BC, Krijnen P, Pieterman H et al (2000) The effect of balloon angioplasty on hypertension in atherosclerotic renal-artery stenosis. Dutch Renal Artery Stenosis Intervention Cooperative Study Group. N Engl J Med 342:1007–1014
Fabbian F, Cacici G, De Biase V et al (2011) Relationship between major adverse cardiac events and angiographic findings in dialysis patients. Int Urol Nephrol 43(4):1171–1178
Sofroniadou S, Kassimatis T, Srirajaskanthan R, Reidy J, Goldsmith D (2012) Long-term safety and efficacy of renin-angiotensin blockade in atherosclerotic renal artery stenosis. Int Urol Nephrol 44(5):1451–1459
Acknowledgments
To the Department of Clinical Research, U.N.Mehta Institute of Cardiology and Research Centre, Ahmedabad for the statistical support.
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Shukla, A.N., Madan, T.H., Jayaram, A.A. et al. Prevalence and predictors of renal artery stenosis in patients undergoing peripheral and coronary angiography. Int Urol Nephrol 45, 1629–1635 (2013). https://doi.org/10.1007/s11255-013-0435-x
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DOI: https://doi.org/10.1007/s11255-013-0435-x