Early atherosclerosis aggravates the effect of renal artery stenosis on the swine kidney.
Atherosclerotic renal artery stenosis (ARAS) is increasingly identified in patients with end-stage renal disease. Renal function in ARAS patients deteriorates more frequently than in nonatherosclerotic renal artery stenosis (RAS). This study was designed to test the hypothesis that atherosclerosis modifies the relationship between single-kidney hemodynamics and function and the severity of stenosis. The degree of unilateral RAS in domestic pigs (4 normal, 26 RAS, and 22 ARAS) was correlated with renal function and hemodynamics evaluated by 64-slice multidetector computerized tomography before and after endothelium-dependent challenge with ACh. The degree of stenosis and increase in mean arterial pressure were similar in RAS and ARAS. Stenotic single-kidney volume, blood flow, glomerular filtration rate, and cortical perfusion were lower than normal in both RAS and ARAS, but only in RAS correlated inversely with increasing degree of stenosis (r = -0.62, r = -0.49, r = -0.51, and r = -0.46, respectively, P < 0.05 for all). Basal tubular fluid concentration capacity and stenotic cortical perfusion response to ACh were both blunted only in ARAS. This study shows that atherosclerosis modulates the impact of a stenosis in the renal artery on stenotic kidney hemodynamics, function, and tubular dynamics. These observations underscore the direct intrarenal effect of atherogenic factors on the kidneys.
Urbieta-Caceres
Victor H
VH
Division of Nephrology and Hypertension, Mayo Clinic, Rochester, Minnesota 55905, USA.
Lavi
Ronit
R
Zhu
Xiang-Yang
XY
Crane
John A
JA
Textor
Stephen C
SC
Lerman
Amir
A
Lerman
Lilach O
LO
D000109:Acetylcholine / Q000494:pharmacology; D000818:Animals; D050197:Atherosclerosis / Q000150:complications* / Q000000981:diagnostic imaging / Q000503:physiopathology; D004195:Disease Models, Animal; D018450:Disease Progression; D004730:Endothelium, Vascular / Q000503:physiopathology; D005260:Female; D005355:Fibrosis; D005919:Glomerular Filtration Rate; D006439:Hemodynamics / Q000187:drug effects; D006978:Hypertension, Renovascular / Q000000981:diagnostic imaging / Q000209:etiology* / Q000503:physiopathology; D007668:Kidney / Q000098:blood supply* / Q000473:pathology / Q000503:physiopathology*; D012077:Renal Artery / Q000000981:diagnostic imaging / Q000187:drug effects / Q000503:physiopathology*; D012078:Renal Artery Obstruction / Q000150:complications* / Q000000981:diagnostic imaging / Q000503:physiopathology; D012079:Renal Circulation / Q000187:drug effects; D012720:Severity of Illness Index; D034421:Sus scrofa; D014057:Tomography, X-Ray Computed; D014665:Vasodilator Agents / Q000494:pharmacology
D014665:Vasodilator Agents; D000109:Acetylcholine
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