Prevalence of renal artery stenosis in diabetes mellitus - an autopsy study

Atherosclerosis is a systemic disease. Although asymmetries in arterial involvement in atherosclerosis may occur, disease usually proceeds in parallel in various organ systems. From a clinical perspective, knowing the prevalence of renal artery involvement in patients with the evidence of atherosclerosis in other organs is important because this knowledge may be incorporated into diagnostic algorithms. This study was aimed to determine the presence of atherosclerotic renal artery disease in diabetes mellitus with coronary artery disease. A total of 173 coronary artery disease patients were purposively selected for the study .Fasting blood sugar level was estimated. Coronary angiograms were performed by standard percutaneous femoral artery cannulation (Judkins Technique).Selective right and left judkins catheter and hand dye injection were used for opacification of renal arteries. Of the 173 study subjects, 143 (diabetic 73) were male and 22 (diabetic 15) were female. Among the diabetic 15 patients had renal artery stenosis and only 7 patients had renal artery stenosis in the non diabetic group. Strength of link between significant renal artery stenosis were strongly correlated (r=0.233, and p, 0.001). Knowledge on the clinical evolution and on the cardiovascular squeal of atherosclerotic renal disease has made substantial progress in recent years. Atherosclerotic renal artery disease is present in significant proportion of diabetic patients undergoing cardiac catheterization for suspected coronary artery disease in comparisons to their non diabetic counter parts. Keywords : Atherosclerosis; Diabetes mellitis; renal artery stenosis DOI: 10.3329/uhj.v5i2.4556 University Heart Journal Vol.5(2) July 2009 pp.63-65

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Diabetes mellitus does not preclude stabilization or improvement of renal function after stent revascularization in patients with kidney insufficiency and renal artery stenosis

Catheterization and Cardiovascular Interventions ◽

10.1002/ccd.20980 ◽

2007 ◽

Vol 69 (6) ◽

pp. 902-907 ◽

Cited By ~ 8

Author(s):

Jose A. Silva ◽

Srinivas Potluri ◽

Christopher J. White ◽

Tyrone J. Collins ◽

J. Stephen Jenkins ◽

...

Keyword(s):

Diabetes Mellitus ◽

Renal Function ◽

Renal Artery ◽

Renal Artery Stenosis ◽

Artery Stenosis ◽

Kidney Insufficiency

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The Relationship Between Renal Artery Stenosis and Degree of Angio Score on the Lower Extremity Peripheral Arterial Disease in Cipto Mangunkusumo Hospital

Journal of Indonesian Society for Vascular and Endovascular Surgery ◽

10.36864/jinasvs.2020.1.003 ◽

2019 ◽

Vol 1 (1) ◽

pp. 10-13

Author(s):

Alexander Jayadi Utama ◽

Hippocrates Kam ◽

Aria Kekalih

Keyword(s):

Diabetes Mellitus ◽

Peripheral Arterial Disease ◽

Lower Extremity ◽

Renal Artery ◽

Renal Artery Stenosis ◽

Significant Relationship ◽

Arterial Disease ◽

Artery Stenosis ◽

Peripheral Arterial ◽

The Relationship

Introduction: The most common cause of the peripheral arterial disease (PAD) is atherosclerosis. PAD is associated with other atherosclerotic diseases such as renal artery stenosis (RAS). Life expectancy decreases in patients with RAS, especially those whose stenosis is above 60% but has not reached the stage of chronic kidney failure. This study aims to determine the prevalence of RAS in PAD patients, the relationship between angiographic scoring system (ANGIO Score), history of hypertension, and diabetes mellitus with the degree of RAS. Method: This research was a cross-sectional study conducted at Cipto Mangunkusumo Hospital from February to May 2019. Patients with a diagnosis of lower extremity PAD and had been assessed with CT angiography examination, were included in this study. The degree of RAS and ANGIO Score were calculated. Sampling was done by the total sampling method. Results Most patients were women 33 (50.8%), while men were 32 (49.2%). 90.8% of the patients had diabetes, while 61.5% of the sample had hypertension. Grade 1 RAS was the most found. There was no correlation between ANGIO Score on age, sex, and diabetes mellitus, but there was a significant relationship with hypertension. There was a relationship between RAS with age and hypertension, but there was no relationship with diabetes mellitus and gender. ANGIO Score and RAS had a significant relationship (p <0.001). Conclusion: There was a relationship between the ANGIO Score and the severity of RAS. The cut-off score of 9 for the ANGIO Score had a sensitivity of 85.7% and a specificity of 61.4% for predicting RAS. Keywords: peripheral arterial disease, angiographic scoring system, renal artery stenosis, CT angiography

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Stent angioplasty of severe atherosclerotic ostial renal artery stenosis in patients with diabetes mellitus and nephrosclerosis

Catheterization and Cardiovascular Interventions ◽

10.1002/ccd.10435 ◽

2003 ◽

Vol 58 (4) ◽

pp. 510-515 ◽

Cited By ~ 86

Author(s):

Thomas Zeller ◽

Christian Müller ◽

Ulrich Frank ◽

Karlheinz Bürgelin ◽

Barbara Horn ◽

...

Keyword(s):

Diabetes Mellitus ◽

Renal Artery ◽

Renal Artery Stenosis ◽

Artery Stenosis ◽

Stent Angioplasty ◽

Patients With Diabetes

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Color-coded summation images in the evaluation of renal artery stenosis before and after percutaneous transluminal angioplasty

BMC Medical Imaging ◽

10.1186/s12880-020-00540-w ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Anne Marie Augustin ◽

Stefan Welsch ◽

Thorsten Alexander Bley ◽

Kai Lopau ◽

Ralph Kickuth

Keyword(s):

Diabetes Mellitus ◽

Serum Creatinine ◽

Renal Artery ◽

Renal Artery Stenosis ◽

Clinical Success ◽

Flow Characteristics ◽

Artery Stenosis ◽

Technical Success ◽

Segmental Artery ◽

Before And After

Abstract Background Endovascular therapy is the gold standard in patients with hemodynamic relevant renal artery stenosis (RAS) resistant to medical therapy. The severity grading of the stenosis as well as the result assessment after endovascular approach is predominantly based on visible estimations of the anatomic appearance. We aim to investigate the application of color-coded DSA parameters to gain hemodynamic information during endovascular renal artery interventions and for the assessment of the procedures´ technical success. Methods We retrospectively evaluated 32 patients who underwent endovascular renal artery revascularization and applied color-coded summation imaging on selected monochromatic DSA images. The differences in time to peak (dTTP) of contrast enhancement in predefined anatomical measuring points were analyzed. Furthermore, differences in systolic blood pressure values (SBP) and serum creatinine were obtained. The value of underlying diabetes mellitus as a predictor for clinical outcome was assessed. Correlation analysis between the patients´ gender as well as the presence of diabetes mellitus and dTTP was performed. Results Endovascular revascularization resulted in statistically significant improvement in 4/7 regions of interest. Highly significant improvement of perfusion in terms of shortened TTP values could be found at the segmental artery level and in the intrastenotical segment (p < 0.001), significant improvement prestenotical and in the apical renal parenchyma (p < 0.05). In the other anatomic regions, differences revealed not to be significant. Differences between SBP and serum creatinine levels before and after the procedure were significant (p = 0.004 and 0.0004). Patients´ gender as well as the presence of diabetes mellitus did not reveal to be predictors for the clinical success of the procedure. Furthermore, diabetes and gender did not show relevant correlation with dTTP in the parenchymal measuring points. Conclusions The supplementary use of color-coding DSA and the data gained from parametric images may provide helpful information in the evaluation of the procedures´ technical success. The segmental artery might be a particularly suitable vascular territory for analyzing differences in blood flow characteristics. Further studies with larger cohorts are needed to further confirm the diagnostic value of this technique.

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