Natural History of Renal Arterial Disease

Meaney, Thomas F.; Dustan, Harriet P.; McCormack, Lawrence J.

doi:10.1148/91.5.881

Cited by 195 publications

(52 citation statements)

References 4 publications

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“…FMD is diagnosed most often in young and middle-aged women, who currently constitute a large part of potential live donors. Majority of the stenotic lesions documented in hypertensive FMD patients are in the mid or distal main renal artery and are bilateral in two-thirds of patients (13)(14)(15). FMD may induce hypertension and ischemic renal failure both in the recipient if transplanted with the lesion and in the donor if the remaining single kidney is affected.…”

Section: Discussionmentioning

confidence: 99%

Rapid Progression of Native Renal Artery Fibromuscular Dysplasia Following Kidney Donation

Parasuraman

Attallah

Venkat

et al. 2004

American Journal of Transplantation

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Fibromuscular dysplasia is the second commonest anatomical abnormality apart from multiple renal arteries in the potential live donors. Pretransplant evaluation of the donors may include an angiography to evaluate the renal arteries, and failure to recognize renal arterial stenosis, particularly fibromuscular dysplasia, by noninvasive methods may eventually lead to hypertension and ischemic renal failure. We report a case of fibromuscular dysplasia that was undetected by computed tomographic angiography prior to donation. One year after kidney donation, it rapidly progressed to severe symptomatic stenosis with hypertension and acute renal failure. Following renal artery angioplasty, her blood pressure normalized over a period of 2 weeks without any need for antihypertensive medications and the serum creatinine returned to her baseline. The acceptability of renal donors with fibromuscular dysplasia depends on the age, race and the availability of the other suitable donors. Mild fibromuscular dysplasia in a normotensive potential renal donor cannot be considered a benign condition. Such donors need regular follow-up postdonation for timely detection and treatment.

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Section: Discussionmentioning

confidence: 99%

Rapid Progression of Native Renal Artery Fibromuscular Dysplasia Following Kidney Donation

Parasuraman

Attallah

Venkat

et al. 2004

American Journal of Transplantation

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“…In these cohorts, significant obstructive renal artery stenoses Atherosclerotic RAS is a progressive disease. In 4 retrospective studies comprising 202 patients followed up for 12 to 60 months, temporal progression of the degree of stenosis occurred in 36% to 71% of patients, and renal artery occlusion occurred in 16% (633)(634)(635)(636). Progression to occlusion is more common in renal arteries with more severe stenoses.…”

Section: Prevalence and Natural Historymentioning

confidence: 99%

ACC/AHA 2005 Practice Guidelines for the Management of Patients With Peripheral Arterial Disease (Lower Extremity, Renal, Mesenteric, and Abdominal Aortic)

Hirsch

Haskal²,

Hertzer³

et al. 2006

Circulation

2,996

1,111

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“…[1][2][3][4][5][6][7][8] Although surgical revascularization has cured or improved blood pressure control, preserved or stabilized renal function, 9 -15 and reversed end-stage renal failure, 16 -18 its morbidity and mortality rates have been higher than those of stent revascularization. 19 -24 Stent revascularization has created the perception of superiority to balloon angioplasty [25][26][27][28][29][30][31] and surgical revascularization, but the paucity of stent publications precludes even historical comparison with surgical data.…”

mentioning

confidence: 99%

Four-Year Follow-up of Palmaz-Schatz Stent Revascularization as Treatment for Atherosclerotic Renal Artery Stenosis

et al. 1998

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Background-Stent revascularization is perceived as superior to balloon angioplasty and surgical revascularization, but the paucity of stent publications precludes even historical comparison with surgical data. Methods and Results-Palmaz-Schatz stent revascularization of renal artery stenosis was successfully performed on 163 consecutive patients for poorly controlled hypertension or preservation of renal function. Of these, 145 were eligible for Ն6-month clinical follow-up of the effect of the procedure on renal function, blood pressure control, number of antihypertensive medications, and survival. At 4 years, systolic and diastolic blood pressures significantly decreased (from 166Ϯ26 to 148Ϯ22 mm Hg and from 86Ϯ14 to 80Ϯ11 mm Hg, respectively; PϽ0.05), and blood pressure control was more facile in approximately half of the patients. Creatinine decreased or remained stable in approximately two thirds of the patients. The cumulative probability of survival was 74Ϯ4% at 3 years, with few deaths related to end-stage renal disease. Survival was good in patients with normal (92Ϯ4%) baseline renal function, fair (74Ϯ7%) in those with mildly impaired renal function, and poor (52Ϯ7%) in patients with elevated baseline creatinine levels (Ն2.0 mg/dL). The combination of impaired renal function and bilateral disease adversely affected survival. Conclusions-Renal artery stent revascularization in the presence of normal or mildly impaired renal function had a beneficial effect on blood pressure control and a nondeleterious effect on renal function. Survival was adversely affected by renal dysfunction despite adequate revascularization. Early diagnosis and adequate revascularization before the onset of renal dysfunction could beneficially affect blood pressure control, preserve or prevent deterioration of renal function, and improve patient survival. (Circulation. 1998;98:642-647.)

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Natural History of Renal Arterial Disease

Cited by 195 publications

References 4 publications

Rapid Progression of Native Renal Artery Fibromuscular Dysplasia Following Kidney Donation

Rapid Progression of Native Renal Artery Fibromuscular Dysplasia Following Kidney Donation

ACC/AHA 2005 Practice Guidelines for the Management of Patients With Peripheral Arterial Disease (Lower Extremity, Renal, Mesenteric, and Abdominal Aortic)

Four-Year Follow-up of Palmaz-Schatz Stent Revascularization as Treatment for Atherosclerotic Renal Artery Stenosis

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