A Single Chinese Center Investigation Of Renal Artery Stenosis In 169 Cases With Coronary Angiography

Object: There is an increasing prevalence of ischemic nephropathy with the aging population in the world. However, the exact incidence for ischemic nephropathy in Chinese population is still uncertain. The present study was to investigate the incidence and risk factor of renal artery stenosis (RAS) in patients with suspected coronary artery disease (CAD) by renal angiography and whether it is necessary to perform the renal angiography in CAD patients.Methods: Renal angiography was performed immediately after coronary artery angiography in 169 patients with suspected CAD,including 76 males,93 females, whose mean ages are 69±8 years old. Comorbidities included hypertension ( n = 80), diabetes mellitus ( n= 27), hyperlipoidemia (n=36), hypopotassium ( n=11) and preoperative renal insufficiency (PRI; Cr >132μmol/L; n = 17).Results: Incidence of RAS was 19.5% (33/169) in 169 patients and 27.1% (19/70) in patients with CAD who were identified by coronary artery angiography. Fourteen cases with renal artery stenosis was found in 99 cases whose coronary arteries were normal (14.1%,14/99). Incidence of RAS in patients with CAD was higher than that in patients with normal coronary artery (27.1% vs. 14.1%,P<0.05). In 70 patients with CAD, incidence of RAS with three vessel lesions was significantly higher than that with one or two vessel lesions.Conclusions: Incidence of RAS is higher in patients with CAD (27.1%). Renal angiography is necessary to be performed in patients accompanied with coronary artery disease for the early detection of the potential RAS.Object: Renal artery stenosis (RAS) is frequently occurred with the aging population, but it is easy to be missed diagnosis clinically for lack of typical manifestations. The study was to clarify the clinical features of RAS in order to increase the possibility of clinical diagnosis.Methods: Renal angiography was performed immediately after coronary artery angiography in 195 patients. There are 42 patients with RAS including 18 males,24 females,whose mean ages are 70±10 years . In these patients, comorbidities included coronary artery disease (CAD; n = 24), hypertension (n = 38), diabetes mellitus (n = 11), hyperlipoidemia (n = 22), hypokalemia (n = 9), cerebral stroke (n = 12) and preoperative renal insufficiency (PRI: Cr >132μmol/L; n = 12).Results: There are significant differences between the RAS group and the non-RAS group for CAD, hypertension, hyperlipodemia, hypokalemia, cerebral stroke, left ventricular hypertrophy, ultrasound discrepancy in the length of the two kidneys (1.5cm) and PRI. Three linked features of CAD,vessel bruits,refractory hypertension had been demonstrated to have a higher incidence of RAS, that is, a sensitivity is 60.3%,a positive predictive value is 91.7%. The incidence of RAS in patients with refractory hypertension and unknown hypokalemia is 54.5%.Conclusions: Our results showed that patients with three linked features(CAD,vascular bruits,refractory hypertension) had a higher risk of suffering from RAS, and renal angiography should be performed.