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Published on: August 28, 2018
[High incidence of renal artery stenosis in patients undergoing coronary angiography]
Jingang Yang1, Dayi Hu, Kunshen Liu
1Cardiovascular Center, Tongren Hospital, Beijing 100730, China.
Insights
Renal artery stenosis is common in patients undergoing coronary angiography. Age, coronary artery disease severity, and peripheral vascular disease are key risk factors for this condition.
Area of Science:
- Cardiovascular Medicine
- Nephrology
- Radiology
Context:
- Atherosclerotic renal artery stenosis (RAS) is a progressive and treatable condition.
- Identifying at-risk patients is crucial for timely intervention.
- Coronary angiography patients often have comorbid atherosclerotic diseases.
Purpose:
- To determine the prevalence of angiographically-proven RAS in patients undergoing coronary angiography.
- To identify clinical risk factors associated with RAS in this population.
Summary:
- This study evaluated 370 patients undergoing coronary angiography, with 28.6% showing some degree of RAS.
- Significant RAS (>50% diameter narrowing) was found in 17.0% of patients.
- Multivariable analysis identified older age, severe coronary artery disease, and peripheral vascular disease as independent predictors of RAS.
Impact:
- Renal artery stenosis is a frequent finding in patients undergoing coronary angiography.
- Highlights the importance of screening for RAS in patients with generalized atherosclerosis.
- Informs clinical practice regarding risk stratification and potential screening in cardiovascular patient cohorts.
Objective:
It is important to identify patients at risk for atherosclerotic renal artery stenosis because renal artery stenosis is a progressive disease and a potentially correctable problem. This study is to evaluate the prevalence of angiographically-determined renal artery stenosis in a patient population undergoing routine coronary angiography, and to identify the risk factors for renal artery stenosis.
Methods:
Before the procedure, demographic data, medical history, physical findings and laboratory data were obtained. After coronary angiography, abdominal aortography was performed to screen for the presence of renal artery stenosis over a 8-month period. In 370 patients (237 males, 133 females), mean age was 60.6 (29 to 81) years. And an univariate and multivariate Logistic regression analysis was made to explore the association of the clinical variables with renal stenosis.
Results:
Renal artery narrowing was identified in 106 (28.6%) patients. Significant renal artery stenosis, defined as a narrowing of the diameter by more than 50%, was found in 63 patients (17.0%) and insignificant (< 50% diameter narrowing) stenosis was found in 43 patients (11.6%). Significant unilateral stenosis was present in 41 (11.1%) patients and bilateral stenosis was present in 22 (5.9%) patients. By univariate and multivariate logistic regression analysis, the association of clinical variables with renal artery stenosis was assessed. Multivariable predictors included age (OR = 1.06, 95% CI: 1.03 approximately 1.10, P < 0.0001), severity of coronary artery disease (OR = 1.65, 95% CI: 1.34 approximately 2.03, P < 0.0001) and peripheral vascular disease (OR = 2.64, 95% CI: 1.27 approximately 5.47, P = 0.0095). The variables such as sex, body mass index, hypertension, smoking history, hyperlipidemia, myocardial infarction, congestive heart failure, renal insufficiency and diabetes mellitus were not associated.
Conclusion:
Renal artery stenosis is a frequent finding in patients undergoing coronary angiography, especially in older people with generalized atherosclerosis.
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