Renal Artery Stenosis in Patients with Ischemic Heart Disease

OBJECTIVE: Renal artery stenosis (RAS) is emerging one of the cause of chronic renal failure and end-stage renal disease. The vast majority of cases in elderly are due to atherosclerotic disease. The prevalence of RAS in several population studies varies considerably. The study aimed to examine the frequency and risk factors of atherosclerotic critical RAS in patients with coronary artery disease.

MATERIAL and METHODS: This study included 762 consecutive patients (456 male and 306 female). All patients underwent coronary and renal angiography at the same time. Significant coronary stenosis is defined as ≥50% stenosis of left main coronary artery and ≥70% stenosis for the other coronary arteries.

RESULTS: A total of 355 patients out of 762 (46%) had at least one coronary vessel involved. The mean age was 62 years. The renal angiography demonstrated significant RAS (≥50%) in 68 patients (8.9%), as well severe stenosis (>80%) in 5 patients. Systolic blood pressure was higher in patients who have significant RAS (p= 0.001). Patients with significant RAS were also more frequently diabetic (73.5% to 26.7%, p=0.001), had dyslipidemia (86.8% to 50%, p= 0.001) and were being treated with statins (72.1% to 28.7%, p= 0.001). The presence of significant RAS was associated with a reduced eGFR (p= 0.001).

CONCLUSION: In patients with ischemic heart disease, screening of the patients with impaired renal functions, diabetes mellitus, advanced age, dyslipidemia and increased pulse pressure is useful for the detection of RAS.