Prevalence and predictors of renal artery stenosis in Chinese patients with coronary artery disease

Abstract

Clinically silent yet angiographically significant ARAS is common among CAD patients. The prevalence and predictors of ARAS among Chinese patients with CAD are similar to those reported for Caucasian subjects. Underlying ARAS should be suspected in CAD patients with such comorbidities as hypertension, renal insufficiency, extracranial cerebrovascular disease, and more so in the elderly and those with multivessel disease.

Angiographic Correlation between Coronary and Renal Artery Lesions in Patients Undergoing Simultaneous Coronary and Renal Angiography

“…This may reflect that traditional risk factors have a limited potential for predicting RAS. Dzieliñska et al 5 and Wang et al 12 were reported similar results, but considerable variability seen in many other studies. In our study, age more than 55 years was an independent predictor of RAS.…”

“…In a number of studies, this issue addressed with different thresholds, in which it was more than 60 years at a minimum. 6,9 Bearing in mind that not all patients with even severe RAS have uncontrolled HTN, renal failure or other clinical clues 1,12 and the fact that well proven anti-atherothrombotic medications which block rennin-angiotensin system may act as a two edged sword in the presence of significant but clinically unsuspected bilateral RAS 1,3 underscores the need to step beyond traditional screening for RAS. Hemodynamically significant RAS may have several deleterious systemic effects through activating this system, which may accelerate atherogenesis and contribute to cardiovascular events.…”

Valsartan Cardio-Renal Protection in Patients Undergoing Coronary Angiography Complicated With Chronic Renal Insufficiency (VAL-CARP) Trial Rationale and Design

“…Previously, several interventional trials have been conducted based on either renal or cardiac evaluation; however, these trials did not simultaneously evaluate both renal and cardiac function. 6,21 Also, little is known regarding the outcome of coronary revascularization in Japanese patients with chronic renal insufficiency. Pinkau et al reported that chronic renal insufficiency was not independently associated with clinical restenosis after coronary revascularization.…”

“…21,[26][27][28] However, the association between patient demographic characteristics, coronary disease burden, extracoronary atherosclerosis, putative manifestations of renal artery stenosis and the prevalence of renal artery stenosis have not been prospectively examined. Atherosclerotic renal artery stenosis as a cause of kidney dysfunction and end-stage renal disease is being increasingly recognized.…”

Prevalence of Renal Artery Stenosis in Patients Undergoing Routine Coronary Angiography

“…[1][2][3][4][5] Atherosclerotic RAS is a progressive disease leading to renal atrophy over time and chronic kidney disease despite control of HTN. [6][7][8][9][10][11][12][13] Presence and severity of incidental RAS is an independent predictor of mortality in atherosclerotic patients regardless of the mode of treatment of underlying coronary artery disease [13][14][15] . The prevalence of RAS has been reported to be in the range of 20-30 percent in high risk populations including patients with known atherosclerotic vascular disease elsewhere.…”