The incidence of renal artery stenosis in the patients referred for coronary artery bypass grafting

Multivessel coronary disease or peripheral arterial disease is the clinical clue to diagnosis of renal artery stenosis (RAS). RAS is considered equivalent to coronary artery disease in terms of cardiovascular risk. In this study, we evaluated the incidence of RAS in the patients who were proposed to...

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Bibliographic Details
Published in:Indian journal of nephrology 2012-01, Vol.22 (1), p.13-17
Main Authors: Liang, F, Hu, D Y, Wu, M Y, Li, T C, Tang, C Z, Wang, J Y, Lu, C L
Format: Article
Language:English
Subjects:
Atherosclerosis
Cardiology
Cardiovascular disease
Clinical medicine
Coronary artery bypass
Coronary heart disease
Coronary vessels
Heart attacks
Intubation
Medical imaging
Original
Renal artery obstruction
Risk factors
Standard deviation
Stenosis
Surgery
Tomography
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Summary:Multivessel coronary disease or peripheral arterial disease is the clinical clue to diagnosis of renal artery stenosis (RAS). RAS is considered equivalent to coronary artery disease in terms of cardiovascular risk. In this study, we evaluated the incidence of RAS in the patients who were proposed to undergo coronary artery bypass grafting (CABG). Diagnostic evaluations of coronary arteriography and renal artery angiography were performed during the same procedure; the patients who were proposed for CABG in terms of CAD anatomy and clinical manifestation were enrolled. RAS was evaluated and a diameter stenosis of ≥50% was considered as significant RAS; significant RAS patients were divided into five groups. The five groups of RAS were as follows: (1) unilateral RAS ≥50-70%, (2) unilateral RAS ≥70%, (3) bilateral RAS ≥50-70%, (4) one-renal-artery stenosis ≥50-70%, contralateral RAS ≥70%, and (5) bilateral renal artery stenosis ≥70%. A total of 151 patients were enrolled, and RAS (≥50% stenosis in either or both renal arteries) was identified in 47.02% (71/151) patients. Unilateral RAS ≥50-70% was identified in 16.6% (25/151) patients, unilateral RAS ≥70% in 4.6% (7/151) patients, bilateral RAS ≥50-70% in 7.9% (12/151) patients, one-renal-artery stenosis ≥50-70% and contralateral RAS ≥70% in 7.9% (12/151) patients, and bilateral RAS ≥70% was in 9.9%(15/151) patients. The incidence of RAS was 29.03% (18/62) in patients aged ≤60 years, 60% (36/60) in patients aged >60 and ≤70 years, and 58.62% (17/29) in patients aged >70 years. The incidence of RAS was significantly higher in patients aged >60 - ≤70, and >70 years than patients aged ≤60 years (P = 0.001 and P = 0.007, respectively). There was a trend that the incidence of RAS in patients with hypertension [HTN, 50.40% (64/127)] was higher than those without HTN (29.17%, 7/24), with P = 0.056. The incidence of RAS was 47.02% in patients who were proposed for CABG; bilateral RAS of ≥70% was 9.9%. Older age and HTN were associated with RAS in patients who were referred for CABG. This study indicates that the incidence of RAS was high in the patients referred for CABG, and the renal function should be taken care of.
ISSN:0971-4065
1998-3662
DOI:10.4103/0971-4065.91181