| Incidental atherosclerotic renal artery stenosis diagnosed at cardiac catheterization: no difference in kidney function with or without stenting. | |
| | |
MedLine Citation:
|
PMID: 18580055 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
|
BACKGROUND: The long-term kidney function of patients with atherosclerotic renal artery stenosis (ARAS) diagnosed incidentally at the time of cardiac catheterization is not well described despite the increasingly common practice of assessing these vessels at the time of cardiac investigation. METHODS: This is a retrospective analysis of a cohort identified prospectively at the time of non-emergent coronary angiography. Those with >or=50% ARAS were managed medically and underwent stenting if recommended by their nephrologist and/or cardiologist. Longitudinal regression analysis was used to compare the annualized change in estimated glomerular filtration rate (GFR) in stented and unstented patients. Cox regression analysis was used to determine the predictors of a decline in GFR by >or=25%. RESULTS: Of 140 patients, 67 (48%) were stented, mostly for preservation of kidney function (70.1%) and/or resistant hypertension (53.7%). Median follow-up time was 943 days. Stented patients were younger, had higher systolic blood pressure and more severe ARAS. The adjusted rate of change in GFR was -1.49 (95% CI -2.33 to -0.65) ml/min/1.73 m(2)/year in the unstented group, and -1.48 (95% CI -2.34 to -0.62) ml/min/1.73 m(2)/year in the stented group (p = 0.99). A decline of GFR >or=25% occurred in 42 (30%) patients; no patient required dialysis. Only the presence of cereberovascular disease was associated with this outcome (hazard ratio 2.52, 95% CI 1.56-5.41). CONCLUSION: We were unable to demonstrate a benefit or harm of renal artery stenting for ARAS, thus further increasing the uncertainty of the significance of these lesions and how they are best managed. |
| | |
Authors:
|
Nadia Zalunardo; Caren Rose; Andrew Starovoytov; Ognjenka Djurdjev; Rebecca Fox; Paul Taylor; John A Duncan; Christopher E H Buller; Adeera Levin |
Related Documents
:
|
15610215 - Management of ischaemic heart disease in women of child-bearing age. 11385155 - Late stent thrombosis after successful rescue of a major coronary artery rupture with a... 18803465 - Aero self-expanding hybrid stent for airway stenosis. 16394595 - Clinical and angiographic outcomes after multi-link penta stent implantation in japanes... 1039985 - A symposium on surgery for coronary artery disease. pre-infarction syndrome--surgical i... 17163985 - Prediction of fluid responsiveness using respiratory variations in left ventricular str... |
Publication Detail:
|
Type: Journal Article Date: 2008-01-16 |
Journal Detail:
|
Title: American journal of nephrology Volume: 28 ISSN: 1421-9670 ISO Abbreviation: Am. J. Nephrol. Publication Date: 2008 |
Date Detail:
|
Created Date: 2008-10-08 Completed Date: 2008-12-03 Revised Date: - |
Medline Journal Info:
|
Nlm Unique ID: 8109361 Medline TA: Am J Nephrol Country: Switzerland |
Other Details:
|
Languages: eng Pagination: 921-8 Citation Subset: IM |
Copyright Information:
|
Copyright 2008 S. Karger AG, Basel. |
Affiliation:
|
Division of Nephrology, Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada. nadia.zalunardo@vch.ca |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
Aged Blood Pressure Cardiovascular Diseases / complications, therapy Coronary Angiography / methods Female Glomerular Filtration Rate Heart Catheterization* Humans Kidney / metabolism, pathology* Male Models, Biological Regression Analysis Renal Artery Obstruction / complications, diagnosis*, pathology Stents Treatment Outcome |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Association analysis of the ephrin-B2 gene in African-Americans with end-stage renal disease.
Next Document: Application of myocardial contrast echocardiography for the perfusion assessment in patients with en...