title: Prospective multicentre study of the natural history of atherosclerotic renal artery stenosis in patients with peripheral vascular disease.
abstract: BACKGROUND
  Many patients with peripheral vascular disease have coincident renal artery stenosis. The present study characterized the natural history of the condition.
  
  
  METHODS
  Some 98 patients (71 men) with more than 50 per cent atherosclerotic renal artery stenosis (unilateral 64, bilateral 34) were recruited prospectively. Measurements of serum creatinine, blood pressure and renal size were recorded at baseline and every 6 months, for a minimum of 2 years.
  
  
  RESULTS
  Data were available for 85 patients with a minimum follow-up of 2 years. The mean age was 71 (range 51-87) years. All 52 patients with unilateral renal artery stenosis were managed conservatively (group 1); 21 of the 33 patients with bilateral disease had no intervention (group 2) and the remaining 12 had angioplasty or reconstruction (group 3). The overall mortality rate was 32 per cent at 2 years (27 patients) and this was similar in all three groups. In only three patients was death related directly to renovascular disease; coronary disease accounted for the majority of deaths. All three patients who needed dialysis died within 1 year. In survivors from groups 1 and 3 there was a significant increase in serum creatinine concentration at follow-up. Blood pressure did not increase significantly.
  
  
  CONCLUSIONS
  Patients with renal artery stenosis and peripheral vascular disease had a poor prognosis, but this was not directly attributable to renal failure.
authors.affiliation: Regional Vascular Unit, St Mary's Hospital, Praed Street, London W2 1NY, UK. willypillay@yahoo.com
authors.forename: W R
authors.initials: WR
authors.lastname: Pillay
authors.forename: Y M
authors.initials: YM
authors.lastname: Kan
authors.forename: J N
authors.initials: JN
authors.lastname: Crinnion
authors.forename: J H N
authors.initials: JH
authors.lastname: Wolfe
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001161:Arteriosclerosis / Q000209:etiology* / Q000473:pathology / Q000503:physiopathology; D001794:Blood Pressure / Q000502:physiology; D018450:Disease Progression; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D016491:Peripheral Vascular Diseases / Q000209:etiology* / Q000473:pathology / Q000503:physiopathology; D011379:Prognosis; D011446:Prospective Studies; D012078:Renal Artery Obstruction / Q000209:etiology* / Q000473:pathology / Q000503:physiopathology; D016019:Survival Analysis