Prospective study of atherosclerotic disease progression in the renal artery

Citation
Mt. Caps et al., Prospective study of atherosclerotic disease progression in the renal artery, CIRCULATION, 98(25), 1998, pp. 2866-2872
Citations number
26
Language
INGLESE
art.tipo
Article
Categorie Soggetti
Cardiovascular & Respiratory Systems","Cardiovascular & Hematology Research
Journal title
CIRCULATION
ISSN journal
0009-7322 → ACNP
Volume
98
Issue
25
Year of publication
1998
Pages
2866 - 2872
Database
ISI
SICI code
0009-7322(199812)98:25<2866:PSOADP>2.0.ZU;2-2
Abstract
Background-The aim of this study was to determine the incidence of and the risk factors associated with progression of renal artery disease in individ uals with atherosclerotic renal artery stenosis (ARAS). Methods and Results-Subjects with greater than or equal to 1 ARAS were moni tored with serial renal artery duplex scans. A total of 295 kidneys in 170 patients were monitored for a mean of 33 months. Overall, the cumulative in cidence of ARAS progression was 35% at 3 years and 51% at 5 years. The 3-ye ar cumulative incidence of renal artery disease progression stratified by b aseline disease classification was 18%, 28%, and 49% for renal arteries ini tially classified as normal, <60% stenosis, and greater than or equal to 60 % stenosis, respectively (P=0.03, log-rank test). There were only 9 renal a rtery occlusions during the study, all of which occurred in renal arteries having greater than or equal to 60% stenosis at the examination before the detection of occlusion. A stepwise Cox proportional hazards model included 4 baseline factors that were significantly associated with the risk of rena l artery disease progression during follow-up: systolic blood pressure grea ter than or equal to 160 mm Hg (relative risk [RR]=2.1; 95% CI, 1.2 to 3.5) , diabetes mellitus (RR=2.0; 95% CI, 1.2 to 3.3), and high-grade (>60% sten osis;or occlusion) disease in either the ipsilateral (RR=1.9; 95% CI, 1.2 t o 3.0) or contralateral (RR 1.7; 95% CI, 1.0 to 2.8) renal artery. Conclusions-Although renal artery disease progression is a frequent occurre nce, progression to total renal artery occlusion is not. The risk of renal artery disease progression is highest among individuals with preexisting hi gh-grade stenosis in either renal artery, elevated systolic brood pressure, and diabetes mellitus.