Frequency of renal artery stenosis and variants of renal vascularization in hypertensive patients: analysis of 1550 angiographies in one centre

Abstract

Renal artery stenosis (RAS) is an important cause of arterial hypertension and chronic kidney disease. The aims of our study were to assess the prevalence of RAS and to examine the frequency of variants of renal vasculature, that is, multiple and/or accessory renal arteries in hypertensive patients referred to renal angiography. We evaluated retrospectively 1554 arteriographies of hypertensive patients. Angiograms were evaluated to find RAS, significant RAS (460% stenosis of the lumen), radiological signs of atherosclerosis, aneurysms of the renal arteries or aorta and variants of kidney vascularization. The frequency of RAS including occlusions was 15.1% (21.3% of them were significant and suitable for revascularization). Variants of renal arterial vascularization were found in 26.5% of patients (multiple renal arteries-11.2% and accessory renal arteries-15.3%). Significant RAS was found more frequently in patients older than 60 years-OR 4.76 (2.08-10.86). Coronary artery disease, history of myocardial infarction or stroke significantly increased the chance of RAS detection. The frequency of renal accessory arteries was lower in patients older than 60 years and in patients with the radiological signs of atherosclerosis. Results of this study indicate that haemodynamically important RAS is found more frequently in hypertensive patients older than 60 years. Symptomatic atherosclerotic disease found in the peripheral and/or coronary arteries and diabetes mellitus increases the chance of RAS detection. Decreased occurrence of renal accessory arteries was found in hypertensive patients with radiological signs of atherosclerosis.

Atherosclerotic Renal Artery Stenosis Prevalence and Correlations in Acute Myocardial Infarction Patients Undergoing Primary Percutaneous Coronary Interventions: Data From Nonrandomized Single‐Center Study (REN‐ACS)—A Single Center, Prospective, Observational Study

“…Data obtained using cardiac catheterization and simultaneous renal angiography (RA) showed that RAS is present in 15% to 20% of CAD patients 6, 7, 8, 9. All previous studies reported data on RAS prevalence in nonemergency CAD.…”

Update on intervention versus medical therapy for atherosclerotic renal artery stenosis

“…2 It is estimated that 15% of hypertensive patients will have evidence of ARAS, with one fifth of them having >60% RAS by angiography. 5 The prevalence among patients with coronary artery disease is estimated to be 5.4% to 38.8%, 6-8 although the incidence is slightly higher in women >60 years old who have ≥coronary artery disease involving two or more vessels. 9 Epidemiologic data suggest that ARAS appears to be a relatively common clinical finding and is present in 6.8% of patients older than 65 years.…”

Smaller caliber renal arteries are a novel feature of uromodulin-associated kidney disease

“…Furthermore, a large retrospective single-center analysis of angiographies failed to detect patients with small caliber renal arteries. 18 The relevance of small caliber renal artery and its relationship to UAKD is not fully understood. The close correlation of renal artery diameter and GFR is noteworthy and one might postulate that hyperuricemia mediates GFR loss and renal artery diameter reduction.…”