Nephrology Dialysis Transplantation, Vol 13, Issue 4 945-948, Copyright © 1998 by Oxford University Press
C Missouris, M Papavassiliou, K Khaw, T Hall, A Belli, T Buckenham and G MacGregor
Background: Renovascular disease is the most
frequently encountered secondary cause of hypertension and is one of the
few potentially reversible causes of chronic renal failure. These patients
are at increased risk of having cerebrovascular events following operative
management for atheromatous renal-artery stenosis. We studied the
prevalence of carotid-artery disease in patients with atheromatous
renal-artery stenosis. Methods: A cross-sectional
study was carried out on 38 consecutive patients with atheromatous
renal-artery stenosis who underwent renal-artery balloon angioplasty.
Extracranial carotid atherosclerosis was assessed using a commercially
available colour Doppler scanner, depending on the velocity of the peak
systolic waveform in the internal carotid artery, and the internal
carotid-artery/common carotid-artery ratio. Results:
Twenty-one patients (55.3%) had normal or mild carotid-artery disease, 10
(26.3%) had moderate, and 7 (18.4%) had severe carotid-artery disease. Nine
patients had previously suffered a stroke (eight infarction, one
haemorrhage) and one had multiple transient ischaemic attacks.
Conclusions: Our results suggest that, in patients
with atheromatous renal-artery disease severe enough to require
angioplasty, 4 out of 10 appear to have moderate to severe carotid-artery
disease. This may explain the increased prevalence of atherothrombotic
cerebrovascular events in these patients, and also previous observations
that, following operative management for atheromatous renal-artery
stenosis, some patients had developed an acute or late cerebrovascular
event. We suggest therefore that such patients should always be regarded as
having generalized vascular disease not confined to one system, and need to
be assessed for carotid-artery disease prior to operative management for
atheromatous renal-artery stenosis. Key words: artery;
atheromatous; carotid; disease; renal
ORIGINAL ARTICLES
High prevalence of carotid artery disease in patients with atheromatous renal artery stenosis
Blood Pressure Unit and Department of Radiology, St George's Hospital Medical School, London, UK; Corresponding author at: Department of Cardiology, St Georges Hospital Medical School, Cranmer Terrace, London SW17 0RE, UK
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