Atherosclerotic ischemic renal disease. Diagnosis and prevalence in an hypertensive and/or uremic elderly population

BMC Nephrology

Rosario Cianci³  Alvaro Zaccaria²  Michele Ferrannini⁵  Daniela Sardella⁵  Guido Ventroni⁶  Michele Rossi⁴  Giuseppe Ronga⁶  Italo Nofroni¹  Eleonora Moscaritolo⁵  Silvia Lai³  Santo Calabria⁵  Giorgio Coen⁵ 

[1]Dep. Experimental Medicine and Pathology, First Medical Faculty, La Sapienza University, Rome, Italy

[2]Dept of Vascular Surgery, First Medical Faculty, La Sapienza University, Rome, Italy

[3]6th Medical Clinic, First Medical Faculty, La Sapienza University, Rome, Italy

[4]Dept of Radiology, First Medical Faculty, La Sapienza University, Rome, Italy

[5]Renal Pathophysiology and Hypertension Unit, Second Medical Faculty, La Sapienza University, Rome, Italy

[6]Nuclear Medicine Unit, First Medical Faculty, La Sapienza University, Rome, Italy

关键词: magnetic resonance angiography;    isotopic renography;    doppler ultrasonography;    chronic renal failure;    atherosclerosis;    renal artery stenosis;   

Others  :  1083455
DOI  :  10.1186/1471-2369-4-2

 received in 2002-08-21, accepted in 2003-02-06,  发布年份 2003

【 摘 要 】

Background

Atherosclerotic ischemic renal disease is a frequent cause of end-stage renal failure leading to dialysis among the elderly; Its prevalence is inferred from autopsy or retrospective arteriographic studies. This study has been conducted on 269 subjects over 50 with hypertension and/or CRF, unrelated to other known causes of renal disease.

Methods

All 269 patients were studied either by color-flow duplex sonography (n = 238) or by renal scintigraphy (n = 224), and 199 of the 269 patients were evaluated using both of these techniques. 40 patients, found to have renal artery stenosis (RAS), were subjected to 3D-contrast enhancement Magnetic Resonance Angiography (MRA) and/or Selective Angiography (SA). An additional 23 cases, negative both to scintigraphy and to ultrasound study, underwent renal angiography (MRA and/or SA).

Results

Color-duplex sonography, carried out in 238 patients, revealed 49 cases of RAS. MR or SA was carried out in 35 of these 49 patients, and confirmed the diagnosis in 33. Color-duplex sonography showed a PPV value of 94.3% and NPV of 87.0% while renal scintigraphy, carried out in 224 patients, had a PPV of 72.2% and a NPV of 29.4%. Patients with RAS showed a higher degree of renal insufficiency compared to non stenotic patients while there were no differences in proteinuria. RAS, based on color-duplex sonography studies, was present in 11% of patients in the age group 50–59, 18% in the 60–69 and 23% at age 70 and above.

Conclusions

A relatively large percentage of the elderly population with renal insufficiency and/or hypertension is affected by RAS and is at risk of developing end-stage renal failure. Color-duplex ultrasonography is a valid routine method of investigation of population at risk for renal artery stenosis.

【 授权许可】

   
2003 Coen et al; licensee BioMed Central Ltd. This is an Open Access article: verbatim copying and redistribution of this article are permitted in all media for any purpose, provided this notice is preserved along with the article's original URL.

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