CLINICAL MANIFESTATIONS OF NONSIGNIFICANT RENAL ARTERY STENOSIS: PP.35.485

Abstract

Background: Renal artery stenosis (RAS) can cause renovascular hypertension (RVH) and ischaemic nephropathy leading to end-stage renal disease. The issue of nonsignificant renal artery stenosis and its clinical correlates is largely unknown. Purpose: To assess the clinical manifestations and the prevalence of target organ damage in nonsignificant renal artery stenosis. Methods: This retrospective study was accomplished in the General Nephrology Unit at the Vilnius university hospital Santariskiu klinikos Out-patient records and discharge summaries of 96 patients were analyzed. There were 42 male (mean age: 54 ± 13,5) and 54 female (mean age: 57 ± 9,5) patients. All subjects underwent computed tomography angiography (CTA) of renal arteries for resistant hypertension and/or unexplained renal failure in the year 2009. All of them had nonsignificant unilateral RAS (diameter reduction < 50%). Imaging echocardiography was performed and signs of damage to the retina caused by hypertension were evaluated in all study subjectst. Labaratory values of serum creatinine, uric acid (UA), 24-hour urine protein, total serum cholesterol were analyzed. Results: Hypertensive retinophaty was detected in 53% of patients; renal failure (creatinine >115 mkmol/l for men, >107 mkmol/l for women) was in 23%; left ventricular hypertrophy (LVH >126,9 g/m2 for men, >112,0 g/m2 for women) was presented in 78% of patients. Normalbuminuria was found in 43,3 % (n = 29), microalbuminuria in 29,9% (n = 20), and macroalbuminuria/proteinuria in 26,9% (n = 18) of analyzed patients. Mean data values of study subjects were as follows: serum creatinine level (mkmol/l): 144 ± 96 (n = 39) in male patients, 99 ± 95 (n = 44) in female patients; uric acid level (mmol/l): 460 ± 271 (n = 10) in male patients; 356 ± 100 (n = 5) in female patients; total cholesterol level: 5,37 ± 1,59 in male patients (n = 28), 5,75 ± 1,79 (n = 25) in female, 24-hour urine protein (mg/24hrs) 486,64 (range 4,00 to 9870,00). Conclusion: The results suggest that even nonsignificant unilateral RAS is responsible for the high prevalence of target organ damage in this condition.