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Survival in renal vascular disease
P J Conlon1, K Athirakul, E Kovalik
1Department of Medicine, Duke University Medical Center, Durham, North Carolina, USA.
Journal of the American Society of Nephrology : JASN
|April 4, 1998
Summary
Renal artery stenosis (RAS) significantly increases 4-year mortality risk. This condition, a potentially reversible cause of renal failure, impacts survival rates in patients undergoing cardiac catheterization.
Area of Science:
- Cardiology
- Nephrology
- Vascular Medicine
Background:
- Renal artery stenosis (RAS) is an uncommon cause of potentially reversible renal failure.
- The natural history of ischemic renal disease secondary to RAS remains poorly understood.
- Previous research identified incidence and risk factors for RAS.
Purpose of the Study:
- To investigate the long-term effects of RAS on all-cause mortality.
- To assess the impact of RAS on 4-year survival rates in a large patient cohort.
Main Methods:
- A cohort of 1235 consecutive patients undergoing cardiac catheterization and abdominal aortography were analyzed.
- Significant RAS was defined as 50% or greater narrowing of a renal artery.
- Cox proportional hazards model was used to identify independent predictors of mortality.
Main Results:
- Four-year survival was lower in patients with RAS (65%) compared to those without (86%).
- Independent predictors of decreased 4-year survival included significant RAS, reduced ejection fraction, elevated serum creatinine, and congestive heart failure symptoms.
- Increased age, peripheral vascular disease, diabetes, and hypertension were also associated with decreased survival.
Conclusions:
- Significant renal artery stenosis is a strong, independent predictor of 4-year mortality.
- RAS contributes to adverse outcomes in patients with cardiovascular disease.
- Identifying and managing RAS is crucial for improving patient survival.