Q J Med 1994; 87: 413-421
© 1994 Association of Physicians
research-article |
Presentation, clinical features and outcome in different patterns of atherosclerotic renovascular disease
Renal Unit, King's College Hospital (Dulwich) 1Department of Radiology London, UK 2Diabetic Department, King's College Hospital London, UK
Address correspondence to Dr I.E. Scoble, Renal Administration, King's College Hospital (Dulwich), London SE22 8PT
Received 21 March 1994 Accepted for publication 13 July 1994.
Atherosclerotic renovascular disease (ARD) is an increasingly important cause of renal failure. However, important features of the clinical presentation are not fully described, and the outcome after intervention by angioplasty remains controversial. Ninety-four patients with ARD diagnosed at angiography were reviewed. Twenty-four patients were diabetic. Thirty-nine patients had unilateral renal artery stenosis or occlusion (group A), 28 had bilateral stenosis (group B), and 27 had unilateral occlusion plus contralateral occlusion or stenosis (group C), Two years after presentation, actuarial patient survival was 96%, 74.3% and 47.1% in groups A, B and C, respectively (p<0.001 for all differences); actuarial renal survival in surviving patients was 97.3%, 82.4% and 44.7%, respectively (p<0.001 for all differences). Percutaneous transluminal balloon angioplasty (PCTA) was performed in 74 patients. Renal function improved in only a minority of cases, but was stable in 73% of nondiabetic patients 12 months after PCTA. Angioplasty was less effective in diabetic subjects, with only 53.3% having stable renal function at 12 months follow-up. Renal and patient survival were strongly related to the initial angiographic findings. In nondiabetic subjects, PCTA resulted in stabilization of renal function for at least one year in nearly threequarters of cases, which suggests a benefit from intervention in this disease whose natural history is otherwise of progression.
CiteULike 
Connotea 
Del.icio.us What's this?
This article has been cited by other articles:
|
|
 |
|
  D. G. Hackam, J. D. Spence, A. X. Garg, and S. C. Textor Role of Renin-Angiotensin System Blockade in Atherosclerotic Renal Artery Stenosis and Renovascular Hypertension Hypertension, December 1, 2007; 50(6): 998 - 1003. [Full Text] [PDF]
|
|
|
|
 |
|
 J. Tan, R. Filobbos, G. Raghunathan, T. Nicholson, R. Fowler, M. Wright, and D. Eadington Efficacy of renal artery angioplasty and stenting in a solitary functioning kidney Nephrol. Dial. Transplant., July 1, 2007; 22(7): 1916 - 1919. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. Chonchol and S. Linas Diagnosis and Management of Ischemic Nephropathy Clin. J. Am. Soc. Nephrol., March 1, 2006; 1(2): 172 - 181. [Full Text] [PDF]
|
|
|
|
 |
|
 C. M. Cheung, J. R. Wright, A.'d. E. Shurrab, H. Mamtora, R. N. Foley, D. J. O'Donoghue, S. Waldek, and P. A. Kalra Epidemiology of Renal Dysfunction and Patient Outcome in Atherosclerotic Renal Artery Occlusion J. Am. Soc. Nephrol., January 1, 2002; 13(1): 149 - 157. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
P.-F. PLOUIN, P. ROSSIGNOL, and G. BOBRIE Atherosclerotic Renal Artery Stenosis: To Treat Conservatively, to Dilate, to Stent, or to Operate? J. Am. Soc. Nephrol., October 1, 2001; 12(10): 2190 - 2196. [Full Text] [PDF]
|
|
|
|
 |
|
 R G Woolfson Renal failure in atherosclerotic renovascular disease: pathogenesis, diagnosis, and intervention Postgrad. Med. J., February 1, 2001; 77(904): 68 - 74. [Full Text]
|
|
|
|
 |
|
 C.G. Isles, S. Robertson, and D. Hill Management of renovascular disease: a review of renal artery stenting in ten studies QJM, March 1, 1999; 92(3): 159 - 167. [Abstract] [Full Text] [PDF]
|
|