Renal artery stenosis and renal parenchymal damage in patients with abdominal aortic aneurysm proven by autopsy.
BACKGROUND
Chronic kidney disease is a major risk factor for patients with cardiovascular diseases (CVD). The aim of this study is to evaluate the relationship between clinical characteristics and renal histology in patients with abdominal aortic aneurysm (AAA).


METHODS
We studied 79 cases with AAA autopsied at the National Cardiovascular Center. They were classified into two groups: 14 subjects with renal artery stenosis (RAS) (group A) and 65 subjects without RAS (group B). Proteinuria, elevated serum creatinine and decreased estimated glomerular filtration rate had been recorded. We evaluated renal parenchymal damage using a semiquantitative histological score (score 0-3; normal to severe) for glomerulosclerosis, interstitial fibrosis, tubular atrophy, and arteriolar hyalinosis (maximal score = 12).


RESULTS
Total histological score was 8.2 +/- 2.4 and significantly higher in the stenosed kidneys of group A than in the non-stenosed kidneys of group B (8.9 +/- 2.6 vs. 8.0 +/- 2.3). The histological score had a significant association with RAS, smoking, kidney function, proteinuria, kidney weight and the presence of other CVD.


CONCLUSIONS
We demonstrated that renal parenchymal damage and deteriorated kidney function are closely associated in the patients with AAA. Treatment of these patients in view of protection of the kidney is thus relevant.
Nakamura
Satoko
S
Department of Medicine, Division of Hypertension and Nephrology, National Cardiovascular Center, Osaka, Japan. snakamur@hsp.ncvc.go.jp
Ishibashi-Ueda
Hatsue
H
Suzuki
Chigure
C
Nakata
Hiroto
H
Yoshihara
Fumiki
F
Nakahama
Hajime
H
Kawano
Yuhei
Y
D000368:Aged; D000369:Aged, 80 and over; D017544:Aortic Aneurysm, Abdominal / Q000150:complications* / Q000175:diagnosis; D001706:Biopsy; D016022:Case-Control Studies; D006801:Humans; D007674:Kidney Diseases / Q000209:etiology* / Q000473:pathology; D007677:Kidney Function Tests; D012078:Renal Artery Obstruction / Q000209:etiology* / Q000473:pathology; D012307:Risk Factors; D012720:Severity of Illness Index