Incidence And Predictors Of Renal Artery Stenosis In Patients With Coronary Artery Disease

Objective: Prevalence of atherosclerotic renal artery stenosis (ARAS) were studied in Patients with coronary artery disease or suspected coronary by angiography, and the degree and location of renal artery stenosis (RAS) were screened, and risk factors of ARAS were identify as early.Methods: 152 patients were studied from October 2004 and September 2005. Patients' data and blood samples were collected before cardiac catherization and renal artery angioplasty were performed. Coronary artery angiography and renal arteriography performed by Seldingers and Judkins technique. Independent variables included: hypertesion,smoking,sex,congestive heart failure,diabetes mellitus,age,peripheral vascular disease,serum creatinine,blood cholesterin and glycerin, and dependent variable was RAS. The significant variables in the univariate model were analyzed in multivariate logistic regression model to identify the best set of independent predictors of RAS. Statistical significance was defined as P<0.05. Results: 152 patients' mean age were 65.43±8.56(95 males,57 females). 32(21.05%) had ARAS, 24 (15.79%) had significant RAS (>50%), Significant unilateral stenosis was 17.1% and bilateral stenosis was 3.95% of the total patients. The ostial lesions was 59.46%, the main stem was35.14% and the branch was 5.4% of 37 renal artery stenosis. By univariate and multivariate logistic regression analysis, predictors included:smoking ( OR=1.26, P=0.044 ),coronary artery disease( OR=1.96, P=0.001 ),hyperlipidemia ( OR=1.91, P=0.003 ),Peripheral vascular disease (OR=1.48, P=0.022), triple coronary artery diseases (OR=1.34, P=0.031).Conclusion: (1) The prevalence of atherosclerotic renal artery stenosis is 15.79% in a patient population undergoing cardiac catheterization and 26.5﹪in CAD patient, RAS is more commom in the ostial sites.(2) Risk factors of ARAS existing are smoking,coronary disease,Peripheral vascular disease,hyperlipidemia,renal insufficience,hypertesion, and independent predictors are hyperlipidemia,smoking,coronary artery disease and Peripheral vascular disease.(3) There is significant correlation between triple vessel diseases of CAD and the presence of ARAS.