Nephrol Dial Transplant (2003) 18: 1147-1151
© 2003 European Renal Association-European Dialysis and Transplant Association
Prevalence of atherosclerotic renal artery stenosis in patients starting dialysis
1 Department of Nephrology and Hypertension, and 2 Department of Radiology, University Medical Center Utrecht, Utrecht, The Netherlands
Background. Atherosclerotic renal artery stenosis (ARAS) can lead to end-stage renal failure (ESRF). We determined the prevalence of ARAS in patients 45 years of age or older starting renal replacement therapy.
Methods. Forty-nine of 80 consecutive patients (37 males, 12 females) starting renal replacement therapy in our centre gave informed consent and underwent spiral computed tomographic angiography of their renal arteries. A renal artery diameter reduction of 50% or more assessed by two radiologists was considered as a significant stenosis.
Results. Twenty of 49 patients (41%) had an ARAS, and in eight cases (16%) this was bilateral or unilateral with a single kidney. Women were more likely to have an ARAS than men; 75 (9/12) vs 30% (11/37, P<0.01). However, relatively more women declined participation. Non-participants and participants did not differ in respect to other relevant clinical data. Nonetheless, findings in these patients would be negative, the prevalence of ARAS would still be 31% in women and 22% in men (NS). In 13 patients with ARAS the registered diagnosis of ESRF either was hypertension, renovascular disease or unknown. Assuming that in these patients atherosclerotic renovascular disease was the cause of renal failure, a total of 13 patients (13/49, 27%) entered the dialysis programme because of this problem.
Conclusions. These results suggest that ARAS is an important cause of ESRF.
Keywords: atherosclerosis; renal artery stenosis; renal failure; renal replacement therapy
Correspondence and offprint requests to: Dr Jaap J. Beutler, Department of Nephrology and Hypertension, University Medical Center Utrecht, Room F03.226, PO Box 85500, 3508 GA Utrecht, The Netherlands. Email: j.j.beutler{at}azu.nl
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