A single chinese center investigation of renal artery stenosis in 141 consecutive cases with coronary angiography.
BACKGROUND
There is an increasing prevalence of ischemic nephropathy in the aging population of the world. However, the exact incidence of ischemic nephropathy in the Chinese population is still uncertain. The present study investigated the incidence of renal artery stenosis (RAS) in patients with suspected coronary artery disease (CAD) using renal angiography.


METHODS
Renal angiography was performed immediately after coronary artery angiography in 141 patients with suspected CAD, including 59 males and 82 females whose mean ages were 59 +/- 10 years. Comorbidities included hypertension (n = 69), diabetes mellitus (n = 21), hyperlipidemia (n = 19), hypokalemia (n = 7) and preoperative renal insufficiency (Cr >132 micromol/l; n = 14). The patients were divided into CAD (luminal narrowing of > or =50%) and non-CAD (luminal narrowing of <50%) subgroups, and RAS (luminal narrowing of > or =50%) and non-RAS subgroups. In the RAS group, there were 11 patients (5 males, 6 females) in whom percutaneous transluminal renal angioplasty was performed in conjunction with stent implantation due to refractory hypertension.


RESULTS
The incidence of RAS was 18.4% (26/141) in all cases and 30.8% (16/52) in patients with CAD identified by coronary artery angiography. Ten cases with RAS were found among the 89 cases with normal coronary arteries (11.2%). The incidence of RAS in patients with CAD was higher than that in patients without CAD (30.8 vs. 11.2%, p< 0.05). In 52 cases with CAD, the incidence of RAS with three vessel lesions was significantly higher than that with one or two vessel lesions. Hypertension, CAD, renal insufficiency, hyperlipidemia and hypokalemia were associated with a higher risk of RAS.


CONCLUSIONS
This study suggests that RAS is very common in the elderly Chinese population, specifically for those with three vessel lesions in CAD. For early detection of potential ischemic nephropathy, renal angiography is necessary in patients who receive coronary artery angiography.
Liu
Bi-Cheng
BC
Institute of Nephrology, Zhong Da Hospital, Southeast University, Nanjing, PR China. kidney@jlonline.com
Tang
Ri-Ning
RN
Feng
Yi
Y
Wang
Yan-Li
YL
Yin
Lian-Fang
LF
Ma
Gen-Shan
GS
D017677:Age Distribution; D000368:Aged; D000792:Angiography; D002681:China / Q000453:epidemiology; D015897:Comorbidity; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000175:diagnosis* / Q000453:epidemiology*; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D012078:Renal Artery Obstruction / Q000175:diagnosis* / Q000453:epidemiology*; D051437:Renal Insufficiency / Q000175:diagnosis / Q000453:epidemiology; D012307:Risk Factors