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A Modified Two Kidney One Clip Mouse Model of Renin Regulation in Renal Artery Stenosis
Published on: October 26, 2020
Renal artery involvement in patients of coronary artery disease undergoing coronary angiography--a prospective study
P C Rath1, M K Agarwala, P K Dhar
1Apollo Hospitals Hyderabad, Jubilee Hills, India.
Insights
This study found a low incidence of significant renal artery stenosis in patients undergoing coronary angiography. While no direct link was found, severe coronary artery disease patients may benefit from renal angiography.
Area of Science:
- Cardiovascular Medicine
- Interventional Cardiology
- Nephrology
Background:
- Renal artery stenosis (RAS) is a significant vascular disease.
- Coronary artery disease (CAD) and RAS often coexist.
- Identifying RAS in CAD patients is crucial for management.
Purpose of the Study:
- To determine the angiographic incidence of renal artery stenosis.
- To explore the association between RAS and cardiovascular risk factors.
- To assess the relationship between RAS and the severity of coronary artery disease.
Main Methods:
- Prospective study of 1000 consecutive patients undergoing coronary angiography.
- Selective renal arteriography performed post-coronary angiography.
- Analysis of patient demographics and cardiovascular risk factors.
Main Results:
- A total of 10.3% of patients had renal artery disease.
- Significant renal artery stenosis (<50%) was found in 2.5% of patients.
- No statistically significant association was found between RAS and common risk factors like diabetes, hypertension, or hypercholesterolemia.
Conclusions:
- The prevalence of significant RAS was low, precluding statistical analysis of its association with CAD severity.
- A trend suggested increased RAS prevalence in patients with severe CAD or multiple risk factors.
- Consideration of renal angiography in specific high-risk CAD subsets is recommended.
Methods:
We prospectively studied the angiographic incidence of renal artery stenosis in 1000 consecutive patients who underwent coronary angiography for clinically suspected coronary artery disease since December, 1998. Selective renal arteriography was performed in all the patients (mean age 57 years, 74.6% males) after coronary angiography.
Results:
Systemic arterial hypertension was present in 52%, 29.1% were smokers, 21% had diabetes and 31.2% had hypercholesterolemia. Significant coronary artery diseases was found in 849 (84.9%) patients. Of the total patient cohort, 103 (10.3%) patients had renal artery disease; 78 (7.8%) had insignificant stenosis (> 50%) and significant renal artery stenosis (< 50%) was identified in 25 (2.5%) patients. Three had bilateral renal artery stenosis. Comparisons were made between renal artery stenosis and risk factor profile. There was no statistically significant association between renal artery stenosis and parameters like diabetes mellitus, hypertension, smoking, lipid levels and serum creatinine.
Conclusion:
In our study, the absolute number of cases with significant renal artery stenosis is small, so no statistical analysis could be performed to demonstrate the relationship of presence of renal artery stenosis with severity of CAD. However patients with severe coronary artery disease or having multiple risk factor showed a trend towards increased prevalence of renal artery stenosis, hence renal angiography should be done for this subset of patients.
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