Prevalence and predictors of renal artery stenosis in patients with coronary artery disease

ABSTRACT

Chronic renal ischemia caused by atherosclerotic renal artery stenosis [ARAS] is gaining recognition as an important risk factor for cardiovascular morbidity and mortality particularly among patients with coronary artery disease [CAD]. The purpose of this study was to determine the prevalence and to identify the predictors of ARAS in patients with CAD diagnosed by coronary angiography at Suez Canal University Hospital. 65 patients proved to have CAD by coronary angiography were underwent renal arteriography in the same setting. Unilateral RAS [>/= 50% luminal narrowing] was identified in 7 [10.8%] patients and 4 [6.2%] had bilateral RAS. These 11 patients [17%] made up the RAS group. 6 patients of the RAS group had high grade [>/= 70%] renal artery lesions [4 unilateral, and 2 bilateral]. Predictors of ARAS in patients with CAD were History of peripheral vascular disease [PVD] [p=0.02], higher levels of serum creatinine [p=0.04], presence of left ventricular hypertrophy [LVH] [p=0.03], presence of multivessel CAD [p<0.001]. The number of coronary arteries with stenotic lesions was the most powerful predictor of significant renal artery stenosis. ARAS is prevalent among patients with multivessel CAD [with >/= 3 diseased segments] with even greater prevalence in the presence of PVD, increased serum creatinine level, and concentric LVH