Prevalence and predictors of renal artery stenosis detected by renal duplex sonography in type 2 diapetes mellitus

ABSTRACT

Diabetes mellitus [DM] is a risk factor for atherosclerosis that may lead to renal artery stenosis [RAS]. This study aimed to screen type 2 diabetic patients for presence of RAS and to identify the main predictors of its presence. The study included 473 patients [204 males and 269 females], aged 40 years or more with a well established DM of more than 5 years duration. Data about smoking, hypertension, diabetic retinopathy, ischemic heart, cercbrovascular and peripheral vascular diseases, macro and microalbuminuria, impaired kidney function and dyslipidemia were collected using history taking, physical examination and appropriate laboratory investigations. Renal ultrasonography and duplex renal scans were obtained for each patient under standardized conditions to determine the size and volume of the kidneys and to evaluate dynamics of the renal blood flow to diagnose RAS. The prevalence of RAS among all patients was 5.9%, and was 11.7% in those with hypertension. Logistic regression analysis was performed to examine and control for the joint effect of multiple factors potentially predicting presence of RAS. The odds ratio [OR] of RAS for the hypothesized predictors were determined to assess the significance of the association. There was a significant association between RAS and presence of abdominal bruit [OR=11.3], difference of length between the two kidneys [OR=3.4], age of patients [OR= 1.6] and duration of DM [OR= 1.1]. RAS is a common complication in type 2 DM. Type 2 DM patients should be scheduled for regular renal duplex check up and this may be done more frequently in patients with certain features that predict presence of RAS