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Published on: September 22, 2020
[Prevalence of renal artery stenosis in patients with critical limb ischemia]
Carlos Esteban1, Ana Presas, Jordi Ara
1Servicio de Angiología y Cirugía Vascular, Hospital Universitario Germans Trias i Pujol, Badalona, Barcelona, España. cesteban.germanstrias@gencat.net
Insights
A high prevalence of renal artery pathology exists in patients with critical limb ischemia. However, no specific clinical or laboratory indicators were found to predict this association in the study.
Area of Science:
- Vascular Medicine
- Nephrology
- Cardiology
Background:
- Critical limb ischemia (CLI) is a severe manifestation of peripheral artery disease.
- Renal artery stenosis (RAS) is a potential comorbidity in patients with atherosclerotic disease.
Purpose of the Study:
- To determine the prevalence of renal artery stenosis in patients presenting with critical limb ischemia.
- To identify potential clinical or laboratory predictors of renal artery pathology in this patient cohort.
Main Methods:
- A consecutive series of 100 patients with critical limb ischemia underwent angiographic evaluation.
- Analysis included assessment of cardiovascular risk factors and renal function parameters.
Main Results:
- Thirty-nine percent of patients exhibited renal artery pathology.
- No significant differences in cardiovascular risk factors (hypertension, diabetes, coronary disease, smoking) or laboratory markers (creatinine, urea, lipids) were observed between patients with and without renal artery stenosis.
- No predictive clinical or laboratory factors were identified.
Conclusions:
- Renal artery pathology is common in patients with critical limb ischemia.
- Current clinical and laboratory assessments do not reliably identify patients with critical limb ischemia who also have renal artery pathology.
Background And Objective:
Our purpose was to evaluate the prevalence of renal artery stenosis in patients with critical limb ischemia and to study any clinical or laboratory indicator that could predict this association.
Patients And Method:
One hundred consecutive patients with critical limb ischemia evaluated by angiogram were included in the study from January to July 2003. Cardiovascular risk factors and renal function were analyzed.
Results:
One hundred angiographic studies have been analyzed. Thirty nine (39%) of our patients had some type of pathology of the renal artery but the rest, 61 (61%), had normal and healthy renal arteries. In 5 patients, a bilateral renal pathology was found. Severe disease (> 60% stenosis, bilateral or renal occlusion) was present in 15 cases including 6 occlusions. Once we compared the patients with healthy renal arteries with the patients with different degrees of stenosis, we did not appreciate significant differences in hypertension, diabetes, coronary disease or smoking habit, nor with laboratory data such as creatinine, urea, c-reactive protein, total cholesterol or atherogenic index. No differences were found either comparing patients with normal renal artery with patients with bilateral pathology or with unilateral occlusion.
Conclusions:
There is a high prevalence of renal artery pathology in patients with critical limb ischemia although we have not found any clinical or laboratory factors useful to identify them.
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