Atherosclerotic Renal Artery Stenosis Tcm Syndromes In A Preliminary Study

Researches showed that end stage renal disease (ESRD) due to atheroscleroticrenal artery stenosis (ARAS) accounted for 16.5% of hemodialysis patients [1]. ARASis seriously threating people's lives, reflecting the severity and extensive of systemicatherosclerosis, while there are still no unified treatments to it, nor could interventionprovide any precise therapy effective evidence. Current research es in ChineseMedicine on treatments to chronic renal failure CRF and atherosclerosis are veryactive, proving to be gaining good effects. Combied treatment of Chinese andWestern Medicine to ARAS may be prospective. However, Chinese Medicineresearches on ARAS is still at a preliminary stage, so it is very important.to explore theetiology pathogenesis, differential diagnosis of ARA to give it target treatments.OBJECTIVE: to investigate differential diagnosis of ARAS and to explore therelationships between it and the clinical index.Methods: cross-sectional survey was adopted to collect materials and differentialdiagnosis of 39 ARAS patients with the inclusive criteria and their degrees ofexcessive-syndromes and deficiency-syndrome were scored. Explore the relationshipbetween the scores and various clinical index such as blood pressure, urine protein(Upro), uric acid (UA), plasma albumin (ALB), serum creatinine (Scr), serumtriglyceride (TG), cholesterol (CHO), high density lipoprotein (HDL), low densitylipoprotein (LDL), renal ultrasonography, glomerula r filtration rate, carotid ultrasound,lower extremity arteries ultrasound. Spearman Correlation and Rank Sum Test wereused. P<0.05 is considered significant.Results:1. common symptoms of ARAS patients were lassitude and weakness, shortness ofbreath and unwillingness to speak, laziness, dim complexion, poor appetite,constriction in the chest, edema and night polyuria.2. The most common deficiency-syndrome among ARAS patients was Qi-deficiencyin spleen and kidney, accounting for 69.2% and the most commonexcessive-syndrome among them was blood-stasis, accounting for 74.4%, andvarious dampness syndromes such as damp-heat, pathogenic dampness, retention ofdampness, and phlegm-damp.3. Scores of deficiency-syndrome had a positive correlation with that ofexcessive-syndrome, suggesting that the basic pathogenosis of ARAS was deficiencyin the origin and excess in superficiality, and it also positively correlated with Scr levels,suggesting that the consumption symptoms might tend to increase as the level ofserum creatinine increased.4. Patients with long-term hypertension, cardiovascular and cerebrovasculardisease were high-risk groups of ARAS and carotid ultrasound examination wasimportant to them.5. Renal length difference might be positively correlated with GFR difference inARAS patients and ALB levels might be negatively correlated to UA levels amongthem.6. Scores of deficiency-syndrome had no correlation with that ofexcessive-syndrome among unilateral renal artery stenosis, bilateral renal arterystenosis and renal artery occlusion groups. ALB and Upro levels were differentbetween unilateral renal artery stenosis and bilateral renal artery stenosis groups, indicating that ALB and Upro might be related to different renal artery stenosisconditions.Conclusion: The characteristic syndrome of ARAS patients was deficiency in theorigin and excess in superficiality, with Qi-dificiency of spleen and kidney as its mostcommon clinical deficiency-syndrome, and blood-stasis and pathogenic dampness asits most common pathogenic factors, all of which indicated that reinforcing Qi,promoting blood circulation and removing dampness might be benefit for ARASpatients.