Atheroembolic renal disease: experience with 22 patients

Atheroembolic renal disease (ARD) following an arteriographic procedure developed in 17 patients over a 107-month period in which 14,998 procedures were performed at two hospitals. The incidence of ARD per arteriographic procedure was 0.1%. A review of all nephrology consults during this same period identified five patients with ARD unrelated to a procedure (spontaneous disease). ARD was diagnosed 5.3 +/- 0.9 weeks following an arteriographic procedure. Patients most likely to be diagnosed with ARD were those recently undergoing arteriography (77%), the elderly (mean 69.9 years), males (73%), Caucasians (95%) and patients with renal insufficiency prior to arteriography. In the patients who had arteriography, the baseline serum creatinine increased significantly from a mean of 3.0 +/- 0.6 mg/dl to 6.6 +/- 1.1 mg/dl at the time of diagnosis (P < .05). The mortality rate of 16 patients who progressed to end stage renal disease was significantly greater (75%) than 6 patients who recovered renal function (17%; P < .05).