title: Renal atrophy in atherosclerotic renovascular disease: gradual changes 6 months after successful angioplasty.
abstract: OBJECTIVE
  To assess renal morphology using spiral computed tomographic angiography (CTA) before and 6 months after angioplasty of unilateral atherosclerotic renal artery stenosis (RAS).
  
  
  METHODS
  Spiral CTA scans from 14 hypertensive patients (7 men; mean age 57.4 +/- 13.1 years) with significant RAS were performed before and 6 months after angioplasty; renal length, mean cortical thickness (MCT), cortical area (CA), and medullary length (ML) were measured from the axial slices in the 14 contralateral and 14 poststenotic then revascularized kidneys. Blood pressure, creatinine clearance, and number of antihypertensive drugs were analyzed.
  
  
  RESULTS
  At 6 months, the systolic blood pressure was significantly reduced (p=0.007), but the number of antihypertensive drugs and the creatinine clearance did not change significantly. Most morphological parameters before and after angioplasty were different in the contralateral versus poststenotic kidneys (renal length, p=0.01; MCT, p=0.01; ML, p=0.03; CA, p=0.008). After angioplasty, there was an 11% drop in cortical atrophy associated with a mean 4-mm increase in medullary length in the poststenotic/revascularized kidneys. The contralateral kidneys exhibited corticomedullary thinning after angioplasty.
  
  
  CONCLUSIONS
  In atherosclerotic renal disease, cortical thinning could be a useful timesaving marker to assess the significance of the lesion and to evaluate associated distal lesions. The favorable blood pressure outcome supports the existence of reversible ischemic lesions, particularly in the medulla. Angioplasty appears to be useful for the poststenotic kidney, according to the morphological study.
authors.affiliation: Services de Médecine Interne et HTA, Hôpital Cardiologique, CHRU, Lille Cedex, France. cmouniervehier@chru-lille.fr
authors.forename: Claire
authors.initials: C
authors.lastname: Mounier-Véhier
authors.forename: Stéphan
authors.initials: S
authors.lastname: Haulon
authors.forename: Christophe
authors.initials: C
authors.lastname: Lions
authors.forename: Patrick
authors.initials: P
authors.lastname: Devos
authors.forename: Olivier
authors.initials: O
authors.lastname: Jaboureck
authors.forename: Serge
authors.initials: S
authors.lastname: Willoteaux
authors.forename: Alain
authors.initials: A
authors.lastname: Carré
authors.forename: Jean-Paul
authors.initials: JP
authors.lastname: Beregi
mesh_terms: D000328:Adult; D000368:Aged; D000800:Angioplasty, Balloon; D001161:Arteriosclerosis / Q000150:complications* / Q000000981:diagnostic imaging / Q000503:physiopathology; D001284:Atrophy / Q000000981:diagnostic imaging / Q000209:etiology / Q000503:physiopathology; D001794:Blood Pressure / Q000187:drug effects / Q000502:physiology; D003971:Diastole / Q000502:physiology; D005260:Female; D006801:Humans; D006978:Hypertension, Renovascular / Q000150:complications* / Q000000981:diagnostic imaging / Q000503:physiopathology; D007668:Kidney / Q000000981:diagnostic imaging / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D012078:Renal Artery Obstruction / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000628:therapy*; D013599:Systole / Q000502:physiology; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome