Prevalence of atherosclerotic renal artery stenosis in patients starting dialysis.
BACKGROUND
Atherosclerotic renal artery stenosis (ARAS) can lead to end-stage renal failure (ESRF). We determined the prevalence of ARAS in patients 45 years of age or older starting renal replacement therapy.


METHODS
Forty-nine of 80 consecutive patients (37 males, 12 females) starting renal replacement therapy in our centre gave informed consent and underwent spiral computed tomographic angiography of their renal arteries. A renal artery diameter reduction of 50% or more assessed by two radiologists was considered as a significant stenosis.


RESULTS
Twenty of 49 patients (41%) had an ARAS, and in eight cases (16%) this was bilateral or unilateral with a single kidney. Women were more likely to have an ARAS than men; 75 (9/12) vs 30% (11/37, P<0.01). However, relatively more women declined participation. Non-participants and participants did not differ in respect to other relevant clinical data. Nonetheless, findings in these patients would be negative, the prevalence of ARAS would still be 31% in women and 22% in men (NS). In 13 patients with ARAS the registered diagnosis of ESRF either was hypertension, renovascular disease or unknown. Assuming that in these patients atherosclerotic renovascular disease was the cause of renal failure, a total of 13 patients (13/49, 27%) entered the dialysis programme because of this problem.


CONCLUSIONS
These results suggest that ARAS is an important cause of ESRF.
Department of Nephrology and Hypertension, University Medical Center Utrecht, Utrecht, The Netherlands.
Jacobine M A
JM
van Ampting
Erik L
EL
Penne
Frederik J A
FJ
Beek
Hein A
HA
Koomans
Walther H
WH
Boer
Jaap J
JJ
Beutler
D000368:Aged; D000792:Angiography / Q000379:methods; D001161:Arteriosclerosis / Q000150:complications / Q000000981:diagnostic imaging / Q000453:epidemiology*; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012078:Renal Artery Obstruction / Q000150:complications / Q000000981:diagnostic imaging / Q000453:epidemiology*; D006435:Renal Dialysis; D036542:Tomography, Spiral Computed / Q000379:methods*