Incidental renal artery stenosis in peripheral vascular disease: a case for treatment?
BACKGROUND
Renal artery stenosis (RAS) is frequently encountered as an incidental finding in peripheral vascular disease. We assessed whether revascularization is indicated to prevent the practical consequences of end-stage renal failure, that is, the need for renal replacement therapy.


METHODS
In a retrospective study, a cohort of consecutive patients was followed who had undergone angiography 8 to 10 years previously for peripheral artery disease. Patients with untreated incidental RAS of > or =50% diameter stenosis (68.8 +/- 9.8 years, mean +/- SD) were compared with regard to the prevalence of renal replacement therapy to controls without RAS who were matched for age and gender.


RESULTS
RAS was present in 126 of 386 evaluable patients (33%). None of these patients required renal replacement therapy during the 10-year follow-up. Serum creatinine values remained stable during follow-up.


CONCLUSIONS
Incidental RAS is frequently seen in patients with peripheral vascular disease. If left untreated, incidental RAS seems not to result in end-stage renal failure or in a need for renal replacement therapy. Revascularization with the aim to prevent end-stage renal failure seems less indicated, and further prospective studies are indicated to elucidate this issue.
Leertouwer
T C
TC
Department of Radiology, Erasmus University Medical Center, Rotterdam, The Netherlands.
Pattynama
P M
PM
van den Berg-Huysmans
A
A
D000368:Aged; D000792:Angiography; D001158:Arteries; D015331:Cohort Studies; D003404:Creatinine / Q000097:blood; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D012078:Renal Artery Obstruction / Q000000981:diagnostic imaging / Q000209:etiology* / Q000628:therapy*; D017582:Renal Replacement Therapy; D012189:Retrospective Studies; D014652:Vascular Diseases / Q000150:complications* / Q000000981:diagnostic imaging
D003404:Creatinine