<b>Prediction of Clinical Response After Renal Angioplasty:</b> Respective Value of Renal Doppler Sonography and Scintigraphy

Soulez, Gilles; Thérasse, Éric; Qanadli, Salah D.; Froment, Daniel; Léveillé, Michel; Nicolet, Viviane; Turpin, Sophie; Giroux, Marie‐France; Guertin, Marie Claude; Oliva, Vincent L.

doi:10.2214/ajr.181.4.1811029

Cited by 52 publications

(23 citation statements)

References 34 publications

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“…In previous reports, a strong correlation was reported between the presence of RAS and renal asymmetry (9,20,23). The 11 th risk factor was an independent and strong marker in our study.…”

Section: Türk Nefroloji Diyaliz Ve Transplantasyon Dergisi Turkish Nesupporting

confidence: 77%

The Evaluation of Clinical Signs in Patients with Suspected Renovascular Hypertension

Tekkarismaz¹,

Torun²,

Özkan³

et al. 2018

Turk Neph Dial Transpl

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OBJECTIVE: Renovascular hypertension (RVH) is the most common yet correctable cause of secondary hypertension if diagnosed early. There are many clinical signs that can suggest RVH. The aim of this study was to find which clinical or laboratory signs are more indicative in diagnosing RVH and in determining which patients should go through renal angiography. MATERIAL and METHODS:The study included 184 patients who presented to our clinic due to hypertension and were under risk of RVH. All patients underwent three-dimensional time-of-flight Magnetic Resonance Angiography with phase-contrast. The patients were divided into two groups as with and without renal artery stenosis, supported by MRA. RESULTS:Advanced age, low body mass index, high serum creatinine level, presence of proteinuria, and patients with diabetes mellitus and coronary artery disease were found to be significant risk factors for RVH. Only the presence of renal asymmetry and the history of coronary artery disease were found to be independent risk factors. CONCLUSION:In conclusion, detailed patient history and the evaluation of renal size are very important for patients with hypertension. Coronary artery disease and a difference in renal size of more than 1.5 cm could be strong indicators of RVH.KEY WORDS: Renovascular hypertension, Renal artery stenosis, Magnetic resonance angiography ÖZ AMAÇ: Renovasküler hipertansiyon (RVH); erken teşhis edildiğinde sekonder hipertansiyonun en fazla düzeltilebilme ihtimali olan nedenlerinden biridir. RVH'u destekleyen pek çok klinik ipucu bulunmaktadır. Çalışmanın amacı, RVH tanısında, klinik ve laboratuvar ipuçlarından hangilerinin daha belirleyici olduğunu bulmak ve renal anjiyografi yapılması gereken hastaları belirlemektir. GEREÇ ve YÖNTEMLER:Çalışmaya hipertansiyon nedeni ile başvuran ve RVH için risk faktörü taşıyan 184 hasta dahil edildi. Tüm hastalara üç boyutlu kontrastlı manyetik rezonans anjiyografi (MRA) uygulandı. Hastalar MRA sonucuna göre; renal arter stenozu olanlar ve olmayanlar şeklinde iki gruba ayrıldı. BULGULAR:İleri yaş, düşük vücut kitle indeksi, yüksek serum kreatinin seviyesi, proteinüri, diabetes mellitus ve koroner arter hastalığı varlığı, RVH için önemli risk faktörleri olarak bulundu. Koroner arter hastalığı öyküsü ile renal asimetri varlığı bağımsız risk faktörü olarak saptandı. SONUÇ: Sonuç olarak, ayrıntılı öykü alınması ve böbrek boyutunun değerlendirilmesi hipertansiyon hastaları için büyük önem taşımaktadır. Koroner arter hastalığı ve böbrek boyutları arasında 1.5 cm'den büyük fark, RVH'nun güçlü birer göstergesi olabilir.

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“…In previous reports, a strong correlation was reported between the presence of RAS and renal asymmetry (9,20,23). The 11 th risk factor was an independent and strong marker in our study.…”

Section: Türk Nefroloji Diyaliz Ve Transplantasyon Dergisi Turkish Nesupporting

confidence: 77%

The Evaluation of Clinical Signs in Patients with Suspected Renovascular Hypertension

Tekkarismaz¹,

Torun²,

Özkan³

et al. 2018

Turk Neph Dial Transpl

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“…Duplex ultrasound has been used to evaluate the results and followup of surgical as well as endovascular interventions 5,15,16 . Few studies investigated whether a high level of resistance to flow in segmental renal arteries measured by duplex US could be used to select appropriate patients for treatment [17][18][19] .…”

Section: Discussionmentioning

confidence: 99%

Índice de resistividade renal como preditor da revascularização renal para hipertensão renovascular

Santos

Leite

Tse³

et al. 2010

Arq. Bras. Cardiol.

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“…Despite its variable sensitivity, pre-and post-captopril renal scintigraphy is widely used to detect renal artery stenosis in adults [26][27][28][29]. There is scant experience in the paediatric population, and the data are limited in children [21,28].…”

Section: Discussionmentioning

confidence: 99%

Reno-vascular hypertension in childhood: a nationwide survey

et al. 2007

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Renovascular disease accounts for 8-10% of all cases of paediatric hypertension, whereas, in adults, its incidence is approximately 1%. The Turkish Paediatric Hypertension Group aimed to create the first registry database for childhood renovascular hypertension in Turkey. Twenty of the 28 paediatric nephrology centres in Turkey responded to the survey and reported 45 patients (27 girls, 18 boys) with renovascular hypertension between 1990 and 2005. The age at presentation ranged from 20 days to 17 years. The mean blood pressure at the diagnosis was 169/110 mmHg. Chief complaints of symptomatic patients were headache (38%), seizure (18%), epistaxis (4%), growth retardation (4%), cognitive dysfunction (4%), polyuria (2%), palpitation (2%), and hemiplegia (2%). Renovascular hypertension was found incidentally in 11 children. The diagnosis of renovascular hypertension was established with conventional angiography in 39 patients, MR angiography in three, CT angiography in two, and captopril diethylene triamine penta-acetic acid (DTPA) scintigraphy in one patient. Twenty-one children had bilateral renal artery stenosis and 24 had unilateral renal artery stenosis. Of these, 14 (31%) had fibromuscular dysplasia; 12 (27%) Takayasu's arteritis; six (13%) neurofibromatosis; two (5%) Williams syndrome; one (2%) Kawasaki disease; one (2%) mid-aortic syndrome; one (2%) extrinsic compression to the renal artery, and eight (18%) unspecified bilateral renal artery stenosis. Hypertension was controlled with antihypertensive drugs in 17 patients. Percutaneous transluminal angioplasty (PTRA) or surgery had to be performed in 28 patients: PTRA in 16 patients, PTRA + surgery in one patient and surgery in 11 patients (four nephrectomies). The importance of vasculitic disease, especially Takayasu's arteritis, should not be underestimated in children with renovascular hypertension.

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Prediction of Clinical Response After Renal Angioplasty: Respective Value of Renal Doppler Sonography and Scintigraphy

Abstract: Measurements of kidney length and unilateral and bilateral resistive indexes before and after captopril administration were useful in predicting the outcome after renal angioplasty. Renal scintigraphy had no significant predictive value.

Cited by 52 publications

References 34 publications

The Evaluation of Clinical Signs in Patients with Suspected Renovascular Hypertension

The Evaluation of Clinical Signs in Patients with Suspected Renovascular Hypertension

Índice de resistividade renal como preditor da revascularização renal para hipertensão renovascular

Reno-vascular hypertension in childhood: a nationwide survey

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