Clinical outcome in patients with peripheral artery disease and renal artery stenosis

There is controversy on the influence of renal artery stenosis on outcome in patients with peripheral artery disease.

The 12-month impact of renal artery stenosis on declining renal function, control of hypertension, and incidence of major cardiovascular events in 100 consecutive patients undergoing angiography for peripheral artery disease was evaluated.

A total of 60 patients had renal artery stenosis: 32 mild, 16 moderate, and 12 severe stenosis. There were no significant differences in either the decline of renal function (2.7 +/- 18% vs 0.9 +/- 16%), control of hypertension (139 +/- 16 vs 139 +/- 22 mm Hg) or number of antihypertensive drugs (1.8 +/- 1.0 vs 1.6 +/- 0.8). Patients with renal artery stenosis had an increased incidence of major cardiovascular events (odds ratio: 2.3; 95% confidence interval: 1.03-5.4), but on multivariate analysis its influence disappeared.

Patients with peripheral artery disease having renal artery stenosis had similar decline of renal function and control of hypertension. They had an increased incidence of major cardiovascular events, but it may be explained by the confounding effect of additional variables.