title: Longterm Outcomes of Renal Artery Involvement in Takayasu Arteritis.
abstract: Takayasu arteritis (TA) involving the renal artery can result in hypertension (HTN), renal dysfunction, and premature death. The aim of this study was to investigate the longterm outcomes and factors that predict outcomes in patients with TA with renal artery stenosis.
  
  
  
  The medical records of patients diagnosed with TA between January 1997 and December 2014 were reviewed retrospectively. Renal artery involvement was based on computed tomography and/or angiography findings. Poor outcome was defined as refractory HTN, chronic renal insufficiency, or death.
  
  
  
  Of the 62 TA patients with renal artery involvement, 11 (17.7%) underwent renal artery revascularization. Younger age, male sex, and more severe stenosis (> 70%) were associated with vascular intervention. After a median followup of 90.6 months, 11 (17.7%) of the 62 patients had refractory HTN and 6 (9.7%) had chronic renal insufficiency. Renal insufficiency [5/15 (33.3%) vs 3/47 (6.4%), p = 0.016] and bilateral involvement [12/15 (80.0%) vs 23/47 (48.9%), p = 0.041] were significantly more frequent in patients with poor than good outcomes. Multivariate Cox analysis revealed that renal insufficiency at presentation (HR 13.778, 95% CI 3.530-53.786, p < 0.001) and bilateral renal artery involvement (HR 5.053, 95% CI 1.179-21.661, p = 0.029) were significant risk factors for poor outcomes at followup, but performance of revascularization procedure was not (HR 0.663, 95% CI 0.176-2.498, p = 0.543).
  
  
  
  Bilateral lesions and renal functional impairment at presentation, but not implementation of revascularization procedures, were significant factors for outcomes in TA patients with renal artery involvement.
authors.affiliation: From the Division of Rheumatology, Department of Internal Medicine, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea.|S. Hong, MD, PhD, Division of Rheumatology, Department of Internal Medicine, University of Ulsan College of Medicine, Asan Medical Center; B. Ghang, MD, Division of Rheumatology, Department of Internal Medicine, University of Ulsan College of Medicine, Asan Medical Center; Y.G. Kim, MD, PhD, Division of Rheumatology, Department of Internal Medicine, University of Ulsan College of Medicine, Asan Medical Center; C.K. Lee, MD, PhD, Division of Rheumatology, Department of Internal Medicine, University of Ulsan College of Medicine, Asan Medical Center; B. Yoo, MD, PhD, Division of Rheumatology, Department of Internal Medicine, University of Ulsan College of Medicine, Asan Medical Center.
authors.forename: Seokchan
authors.initials: S
authors.lastname: Hong
authors.affiliation: From the Division of Rheumatology, Department of Internal Medicine, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea.|S. Hong, MD, PhD, Division of Rheumatology, Department of Internal Medicine, University of Ulsan College of Medicine, Asan Medical Center; B. Ghang, MD, Division of Rheumatology, Department of Internal Medicine, University of Ulsan College of Medicine, Asan Medical Center; Y.G. Kim, MD, PhD, Division of Rheumatology, Department of Internal Medicine, University of Ulsan College of Medicine, Asan Medical Center; C.K. Lee, MD, PhD, Division of Rheumatology, Department of Internal Medicine, University of Ulsan College of Medicine, Asan Medical Center; B. Yoo, MD, PhD, Division of Rheumatology, Department of Internal Medicine, University of Ulsan College of Medicine, Asan Medical Center.
authors.forename: Byeongzu
authors.initials: B
authors.lastname: Ghang
authors.affiliation: From the Division of Rheumatology, Department of Internal Medicine, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea.|S. Hong, MD, PhD, Division of Rheumatology, Department of Internal Medicine, University of Ulsan College of Medicine, Asan Medical Center; B. Ghang, MD, Division of Rheumatology, Department of Internal Medicine, University of Ulsan College of Medicine, Asan Medical Center; Y.G. Kim, MD, PhD, Division of Rheumatology, Department of Internal Medicine, University of Ulsan College of Medicine, Asan Medical Center; C.K. Lee, MD, PhD, Division of Rheumatology, Department of Internal Medicine, University of Ulsan College of Medicine, Asan Medical Center; B. Yoo, MD, PhD, Division of Rheumatology, Department of Internal Medicine, University of Ulsan College of Medicine, Asan Medical Center.
authors.forename: Yong-Gil
authors.initials: YG
authors.lastname: Kim
authors.affiliation: From the Division of Rheumatology, Department of Internal Medicine, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea.|S. Hong, MD, PhD, Division of Rheumatology, Department of Internal Medicine, University of Ulsan College of Medicine, Asan Medical Center; B. Ghang, MD, Division of Rheumatology, Department of Internal Medicine, University of Ulsan College of Medicine, Asan Medical Center; Y.G. Kim, MD, PhD, Division of Rheumatology, Department of Internal Medicine, University of Ulsan College of Medicine, Asan Medical Center; C.K. Lee, MD, PhD, Division of Rheumatology, Department of Internal Medicine, University of Ulsan College of Medicine, Asan Medical Center; B. Yoo, MD, PhD, Division of Rheumatology, Department of Internal Medicine, University of Ulsan College of Medicine, Asan Medical Center.
authors.forename: Chang-Keun
authors.initials: CK
authors.lastname: Lee
authors.affiliation: From the Division of Rheumatology, Department of Internal Medicine, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea. byoo@amc.seoul.kr.|S. Hong, MD, PhD, Division of Rheumatology, Department of Internal Medicine, University of Ulsan College of Medicine, Asan Medical Center; B. Ghang, MD, Division of Rheumatology, Department of Internal Medicine, University of Ulsan College of Medicine, Asan Medical Center; Y.G. Kim, MD, PhD, Division of Rheumatology, Department of Internal Medicine, University of Ulsan College of Medicine, Asan Medical Center; C.K. Lee, MD, PhD, Division of Rheumatology, Department of Internal Medicine, University of Ulsan College of Medicine, Asan Medical Center; B. Yoo, MD, PhD, Division of Rheumatology, Department of Internal Medicine, University of Ulsan College of Medicine, Asan Medical Center. byoo@amc.seoul.kr.
authors.forename: Bin
authors.initials: B
authors.lastname: Yoo
mesh_terms: D000293:Adolescent; D000328:Adult; D017130:Angioplasty; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012077:Renal Artery / Q000000981:diagnostic imaging / Q000601:surgery*; D012078:Renal Artery Obstruction / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery*; D051437:Renal Insufficiency / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery*; D012189:Retrospective Studies; D015607:Stents; D013625:Takayasu Arteritis / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D055815:Young Adult
keywords: HYPERTENSION; RENAL ARTERY; REVASCULARIZATION; TAKAYASU ARTERITIS