European Journal of Radiology

1990

DOI: 10.1016/0720-048x(90)90137-z

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The angiographic incidence of renal artery stenosis in the arteriosclerotic population

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Cited by 64 publications

(17 citation statements)

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“…The above-quoted studies involve the patients with clinical symptoms of atherosclerosis, which presumes more severe disease and this may explain a higher percentage of RAS than found in this study. Moreover, our patients were markedly (over 10 years) younger (45 ± 14 vs 62 ± 9 years) than those in Wilms' et al 5 study. In the study of van Jaarsveld et al…”

Section: Discussioncontrasting

confidence: 59%

“…In addition, the important methodological differences between studies make them difficult to compare. Wilms et al 5 have shown the 22% prevalence of RAS (450% of lumen) in patients with peripheral arterial occlusive disease. In their small subgroup (n ¼ 43) of hypertensive patients the RAS prevalence reached 28%.…”

Section: Discussionmentioning

confidence: 98%

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

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et al. 2009

J Hum Hypertens

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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.

“…The above-quoted studies involve the patients with clinical symptoms of atherosclerosis, which presumes more severe disease and this may explain a higher percentage of RAS than found in this study. Moreover, our patients were markedly (over 10 years) younger (45 ± 14 vs 62 ± 9 years) than those in Wilms' et al 5 study. In the study of van Jaarsveld et al…”

Section: Discussioncontrasting

confidence: 59%

“…In addition, the important methodological differences between studies make them difficult to compare. Wilms et al 5 have shown the 22% prevalence of RAS (450% of lumen) in patients with peripheral arterial occlusive disease. In their small subgroup (n ¼ 43) of hypertensive patients the RAS prevalence reached 28%.…”

Section: Discussionmentioning

confidence: 98%

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

¹

,

²

,

³

et al. 2009

J Hum Hypertens

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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.

“…16 In multiple series of PAD cases, the rates of RAS varied from 12.0 to 45.5%, with a pooled prevalence of 25.3%. 16 Wilms et al 17 found a 22% prevalence of RAS X50% in patients with PAD (mean age 62.4 years old), and Amighi et al 1 recently reported a prevalence of RAS X60% on angiography of 15.6% in patients with PAD (mean age 70.6 years old). Thus, our results for the rate of RAS in Japanese patients with PAD are similar to those found in previous studies.…”

Section: Discussionmentioning

confidence: 99%

Prevalence and risk factors for renal artery stenosis and chronic kidney disease in Japanese patients with peripheral arterial disease

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et al. 2010

Hypertens Res

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The prevalence and risk factors for renal artery stenosis (RAS) and chronic kidney disease (CKD) are unclear in Japanese patients with peripheral arterial disease (PAD). To examine these issues, we performed renal angiography in 410 patients with PAD. Renal function and damage were assessed using the estimated glomerular filtration rate (eGFR) and urinary level of microalbumin (MA). Multiple logistic and multiple regression analyses were used to examine the relationships of potential risk factors with RAS and CKD. In all, 94 subjects (22.9%) had RAS 450% and 45 subjects (11.0%) had RAS 475%. The incidences of an abnormal level of MA and renal insufficiency (eGFR o60 ml min -1 per 1.73 m 2 ) were 37.0 and 60.7%, respectively. RAS X50% was associated with critical limb ischemia (CLI; hazard ratio (HR) 2.519; 95% confidence interval (CI) 1.203-5.276, P¼0.014), coronary heart disease (CHD; HR 2.143; 95% CI 1.129-4.069; P¼0.020) and hypertension (HR 1.907; 95% CI 1.009-3.628; P¼0.045). RAS X75% had a relationship with hypertension (HR 3.093; 95% CI 1.002-9.548; P¼0.048). eGFR was negatively correlated with age, uric acid and CHD (P¼0.013), and MA had a significant positive correlation with low-density lipoprotein cholesterol, CLI, age, CHD and diabetes (Po0.001). These results show that the prevalences of RAS and CKD are very high in Japanese patients with PAD; that CLI and CHD are major risk factors for RAS; and that hyperuricemia, hypercholesterolemia and diabetes are risk factors for CKD in PAD. We also found that MA is a simple and noninvasive marker of renal dysfunction and general vascular damage.

“…[1][2][3][4][5][6][7][8][9][10] In the Japanese population, according to previous study of simultaneous angiographic examination and cardiac catheterization, 6.4% of patients with CAD had significant RAS. 21 Autopsy studies report that approximately 12% of Japanese patients with myocardial infarction or stroke had RAS.…”

Section: Discussionmentioning

confidence: 99%

Renal Artery Stenosis in Cardio-and Cerebrovascular Disease Renal Duplex Ultrasonography as an Initial Screening Examination

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et al. 2007

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Background The prevalence and indicative clinical factors of renal artery stenosis (RAS) in the Japanese population are unclear. Methods and ResultsThe aim of this study was to investigate the prevalence of RAS in a selectively referred Japanese population and to determine any clinical factors related to RAS by initially screening with renal duplex ultrasonography. The 750 patients presenting because of possible or known cardio-and cerebrovascular diseases were prospectively studied. Duplex examination was performed in 729 patients (97.2%): 21 patients (2.8%) did not undergo it, because of technical impossibility. Duplex RAS was found in 38 patients (5.2%). Subsequently, a confirmatory renal angiography was obtained in 40 patients, investigating those who had duplex RAS or no duplex examination. Angiographic RAS was found in 35 patients (4.8%). The respective prevalences of duplex and angiographic RAS were 6.3% and 6.7% in coronary artery disease, 8.8% and 9.3% in multivessel coronary artery disease, 7.5% and 8.2% in heart failure, 5.1% and 4.3% in unstable angina pectoris, 20.0% and 22.2% in carotid artery stenosis, 10.3% and 10.2% in stroke, 20.0% and 20.0% in peripheral artery disease, and 12.0% and 11.8% in abdominal aortic aneurysm. Univariate analysis showed that patients with duplex RAS were older and had more atherosclerotic risk factors. Furthermore, they were more likely to be smokers and have hypertension, renal impairment, renal atrophy, left ventricular hypertrophy and cardio-and cerebrovascular diseases. Multivariate stepwise analysis showed that smoking, peripheral artery disease, abdominal aortic aneurysm and renal atrophy were independent predictors of duplex RAS. Conclusions RAS is frequent in Japanese patients with cardio-and cerebrovascular diseases. Initial screening for RAS by duplex ultrasonography is recommended for patients with complications, especially peripheral artery disease, abdominal aortic aneurysm and renal atrophy. (Circ J 2007; 71: 1942 -1947

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