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NDT Advance Access published online on February 18, 2009
Nephrology Dialysis Transplantation, doi:10.1093/ndt/gfp051
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© The Author [2009]. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved. For Permissions, please e-mail: journals.permissions@oxfordjournals.org


Incidental renal artery calcifications: a study of 350 consecutive abdominal computed tomography scans

Lior Tolkin1, Michael Bursztyn1, Iddo Z. Ben-Dov2, Natalia Simanovsky3 and Nurith Hiller3

1 Department of Medicine 2 Department of Nephrology 3 Department of Radiology, Hadassah—Hebrew University Medical Center, Mount-Scopus, Jerusalem, Israel

Correspondence and offprint requests to: Michael Bursztyn, Department of Medicine, Hypertension Unit, Hadassah—Hebrew University Medical Center, Mount-Scopus, PO Box 24035, Jerusalem 91240, Israel. Tel: +972-25844706; Fax: +972-25844705; E-mail: bursz{at}cc.huji.ac.il



  Abstract

Background. Calcifications in arteries are thought to represent atherosclerosis.

Methods. Consecutive abdominal tomographic scans performed during a 4-month period were evaluated and assessed for renal artery calcifications (RAC). Scans that showed calcifications were evaluated for renal artery narrowing and for various characteristics of the atherosclerotic plaque.

Results. Of 350 consecutive examinees, 43% were men, 40% had hypertension and 38% had hypercholesterolaemia. The age was 61 ± 13 years. Aortic calcifications were found in 54% and RAC in 102 (29%), of whom 53 had bilateral calcifications. Subjects with RAC were older, 72 ± 6 versus 55 ± 12 years. Adjusted odds ratios of RAC were 2.2 (95% CI 1.1–4.6) for male gender, 2.4 (1.2–4.8) for hypertension and 2.9 (1.4–5.8) for hypercholesterolaemia, whereas family history of hypertension was protective with 0.5 (0.3–0.9). All patients with calcified renal arteries had aortic calcifications, versus 35% of those without RAC. A significant correlation was found between the severity of calcifications and the degree of renal artery narrowing (r = 0.7), and also between the presence of bilateral calcifications and a high-grade narrowing.

Conclusions. RAC strongly relates to atherosclerosis. Calcifications and artery narrowing may have a role in the pathogenesis of hypertension. Bilateral calcifications suggest atherosclerotic renal artery stenosis.

Keywords: computed tomography; hypertension; renal artery calcification; renal artery stenosis

Received for publication: 4.11.08
Accepted in revised form: 23. 1.09


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