Document Detail


The profile of cardiac patients with renal artery stenosis.
MedLine Citation:
PMID:  15120819     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: We examined the prevalence and severity of renal artery stenosis (RAS) in patients undergoing cardiac catheterization who were deemed at risk for RAS based on clinical or laboratory criteria for study entry, but who had not previously been suspected of having RAS. BACKGROUND: The diagnosis of atherosclerotic RAS remains problematic because its clinical manifestations are nonspecific. METHODS: Consecutive patients undergoing non-emergent cardiac catheterization at a single institution during a 12-month period were evaluated using standardized clinical, laboratory, and angiographic criteria. Patients exhibiting at least one of four predefined selection criteria (severe hypertension, unexplained renal dysfunction, acute pulmonary edema with hypertension, or severe atherosclerosis) were prospectively registered and underwent coincident diagnostic renal angiography. RESULTS: Renal angiography was performed in 851 patients and was diagnostic in 837. Angiographically evident renal atherosclerosis was present in 39% of the population, with RAS > or =50% in 120 (14.3%) and severe stenosis (> or =70%) in 61 (7.3%). Severe stenosis was present in 48 (7%) patients with severe atherosclerosis, 38 (16%) with renal dysfunction, 25 (9%) with hypertension, and 2 (22%) with acute pulmonary edema with hypertension. The prevalence was higher in those exhibiting multiple selection criteria. In a multivariate model, severe RAS was associated with age, female gender, reduced creatinine clearance, increased systolic blood pressure, and peripheral or carotid artery disease. CONCLUSIONS: In a population at risk of, but not previously suspected of having RAS, severe RAS is associated with simple and readily determined clinical and laboratory patient characteristics. These data facilitate focused application of diagnostic renal angiography.
Authors:
Christopher E Buller; Jorge G Nogareda; Krishnan Ramanathan; Donald R Ricci; Ognjenka Djurdjev; Kathryn J Tinckam; Ian M Penn; Rebecca S Fox; Lesley A Stevens; John A Duncan; Adeera Levin
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Publication Detail:
Type:  Comparative Study; Evaluation Studies; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Journal of the American College of Cardiology     Volume:  43     ISSN:  0735-1097     ISO Abbreviation:  J. Am. Coll. Cardiol.     Publication Date:  2004 May 
Date Detail:
Created Date:  2004-05-03     Completed Date:  2004-06-10     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  8301365     Medline TA:  J Am Coll Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1606-13     Citation Subset:  AIM; IM    
Affiliation:
Department of Medicine, Division of Cardiology, University of British Columbia, Vancouver, Canada. cbuller@providencehealth.bc.ca
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MeSH Terms
Descriptor/Qualifier:
Adult
Age Factors
Aged
Aged, 80 and over
Canada / epidemiology
Coronary Angiography
Coronary Disease / diagnosis*,  epidemiology
Female
Heart Catheterization
Humans
Hypertension, Renovascular / diagnosis,  epidemiology
Kidney Failure / diagnosis,  epidemiology
Male
Middle Aged
Multivariate Analysis
Patient Satisfaction
Prevalence
Prospective Studies
ROC Curve
Renal Artery Obstruction / diagnosis*,  epidemiology
Severity of Illness Index
Sex Factors
Comments/Corrections
Comment In:
J Am Coll Cardiol. 2004 May 5;43(9):1614-6   [PMID:  15120820 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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