Document Detail


Evaluation of characteristics, associations and clinical course of isolated spontaneous renal artery dissection.
MedLine Citation:
PMID:  23563282     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Spontaneous renal artery dissection (SRAD) is a rare entity of unknown etiology. We aimed to study the clinical course and outcomes and compare the characteristics of patients with SRAD with those of the general population.
METHODS: All cases of isolated renal artery dissection diagnosed at the University of Michigan Hospitals between January 2000 and July 2012 were identified by the ICD-9 code. Cases were matched by age, gender and race with individuals from the 2009-2010 National Health and Nutrition Examination Survey (NHANES). Characteristics and awareness of comorbid conditions were compared. Information about the clinical course after diagnosis was retrieved from the case group to ascertain their outcomes.
RESULTS: Overall, 17 patients with SRAD with a mean age of 38.6 years (SD = 8.3) were identified. Eleven patients were male and 14 were white. The most common presenting symptom was excruciating sudden-onset flank pain ipsilateral to the site of dissection. Fibromuscular dysplasia, Ehlers-Danlos and polyarteritis nodosa were present in 4, 4 and 1 patients, respectively. After adjusting in a multivariable model, the case group was more likely to report history of hypertension, cancer and connective tissue disorders (P < 0.001), and less likely to have obesity (BMI ≥30 kg/m(2)) compared with the general population. Supportive medical treatment, endovascular intervention and surgery were required in 8, 5 and 4 cases, respectively. After discharge from the hospital, hypertension was adequately controlled in all the patients but one.
CONCLUSION: SRAD may be part of a syndrome having multi-organ involvement. With appropriate medical or surgical management, long-term clinical outcome appears favorable.
Authors:
Farsad Afshinnia; Baskaran Sundaram; Panduranga Rao; James Stanley; Markus Bitzer
Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, N.I.H., Extramural     Date:  2013-04-05
Journal Detail:
Title:  Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association     Volume:  28     ISSN:  1460-2385     ISO Abbreviation:  Nephrol. Dial. Transplant.     Publication Date:  2013 Aug 
Date Detail:
Created Date:  2013-09-09     Completed Date:  2014-04-03     Revised Date:  2014-08-03    
Medline Journal Info:
Nlm Unique ID:  8706402     Medline TA:  Nephrol Dial Transplant     Country:  England    
Other Details:
Languages:  eng     Pagination:  2089-98     Citation Subset:  IM    
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MeSH Terms
Descriptor/Qualifier:
Adult
Aneurysm, Dissecting / complications,  pathology,  surgery*
Case-Control Studies
Female
Fibromuscular Dysplasia / diagnosis*,  etiology
Follow-Up Studies
Humans
Male
Postoperative Complications*
Prognosis
Renal Artery / pathology,  surgery*
Retrospective Studies
Vascular Diseases / complications,  pathology,  surgery*
Grant Support
ID/Acronym/Agency:
5T32DK7378-32/DK/NIDDK NIH HHS; T32 DK007378/DK/NIDDK NIH HHS
Comments/Corrections

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