scholarly journals Depression and anxiety in patients with suspected renal artery stenosis

2021 ◽  
Vol 5 (1) ◽  
pp. 016-024
Author(s):  
Hallberg Ludvig ◽  
Gottsater Anders ◽  
Isaksson Anders ◽  
Westrin Asa
Keyword(s):  
Renal Artery ◽  
Renal Artery Stenosis ◽  
Artery Stenosis ◽  
Depression And Anxiety ◽  
Psychiatric Examination ◽  
Renal Angioplasty ◽  
Symptoms Of Depression ◽  
Percutaneous Transluminal Renal Angioplasty ◽  
Dsm Iv ◽  
A Current

Objective: To investigate the occurrence of depressive and anxiety disorders in patients remitted for endovascular treatment of renal artery stenosis (RAS), and whether symptoms of depression and anxiety can be reduced after the treatment of RAS with percutaneous transluminal renal angioplasty (PTRA). Methods Patients: Selected for renal angiography with pressure measurement in the renal arteries due to suspected RAS were invited to participate in the study. 37 patients agreed to answer a questionnaire. Eighteen patients also agreed to a clinical psychiatric examination including the International Neuropsychiatric Interview (M.I.N.I. 6.0) to be diagnosed according to the DSM-IV. Results: Twenty-one of the 37 patients completing the questionnaire were found to have a pressure gradient of ≥ 10 mmHg at angiography, indicating significant stenosis. Ten of the 18 examined patients met the criteria for current DSM-IV anxiety diagnosis and two patients had a current depression. Three of the 18 examined patients had previously made a suicide attempt. Conclusion: The results of this study suggest that patients with suspected RAS have a high psychiatric comorbidity, as 56% of the patients undergoing psychiatric examination met the DSM-IV criteria for a current anxiety disorder.

Effect of Percutaneous Transluminal Renal Angioplasty on Absolute Split Renal Function in Patients with Renovascular Hypertension. Influence of Age and Other Parameters

1993 ◽  
Vol 60 (1) ◽  
pp. 27-33
Author(s):  
M. Takeda ◽  
Y. Katayama ◽  
K. Saito ◽  
T. Tsutsui ◽  
T. Komeyama ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Renal Function ◽  
Renal Artery ◽  
Renal Artery Stenosis ◽  
Plasma Renin ◽  
Artery Stenosis ◽  
Renal Angioplasty ◽  
Split Renal Function ◽  
Percutaneous Transluminal Renal Angioplasty ◽  
Percutaneous Transluminal

Tc99m-dimercaptosuccinic acid renal uptake (DMSA uptake) was examined to assess the changes in split renal function following percutaneous transluminal renal angioplasty (PTRA) in 9 patients with a total of 12 renal artery stenoses and renovascular hypertension (RVH). The results were studied with respect to age, degree of renal artery stenosis, and renal vein renin ratio (RVRR) before PTRA. Although the degree of renal artery stenosis, systolic blood pressure, and peripheral blood plasma renin activity were improved 3 months after PTRA, neither the DMSA uptake of the affected kidneys nor that of the contralateral kidneys improved. Although restenosis occurred during the long follow-up period in one patient, DMSA uptake did not change in parallel with the degree of stenosis or RVRR. The degree of improvement in DMSA uptake, blood pressure, and plasma renin activity after PTRA in patients aged under 70 years was significantly higher than that in patients 70 years or older. Good improvement of renal function was attained in a 4-year-old boy, despite the fact that split renal function prior to PTRA was so poor that nephrectomy had been considered instead of PTRA. These results suggest that several factors before PTRA, such as DMSA uptake, degree of renal artery stenosis, and RVRR, are not absolutely predictive of results after PTRA, and that the effect of PTRA on blood pressure and renal function is greater in younger patients.

Current state of diagnosis and endovascular treatment of renal artery stenosis

VASA ◽  
2006 ◽  
Vol 35 (3) ◽  
pp. 147-155 ◽  
Author(s):  
Zeller
Keyword(s):  
Renal Artery ◽  
Renal Artery Stenosis ◽  
Pressure Control ◽  
Left Ventricular ◽  
Artery Stenosis ◽  
Atherosclerotic Renal Artery Stenosis ◽  
Renal Angioplasty ◽  
Current State ◽  
Percutaneous Transluminal Renal Angioplasty ◽  
The Impact

Renal artery stenosis may cause or deteriorate arterial hypertension and/or renal insufficiency. Technical improvements of diagnostic and interventional endovascular tools have lead to a more widespread use of endoluminal renal artery revascularization and extension of the indications for this type of therapy. Since the first renal artery angioplasties performed by Felix Mahler and Andreas Grüntzig in 1978, numerous single centre studies have reported the beneficial effect of percutaneous transluminal renal angioplasty, and since the early 1990’s stenting of renal artery stenosis caused either by atherosclerosis or fibromuscular dysplasia. This article summarizes the impact of technical improvements of endovascular tools on interventional techniques during the last decade and gives an overview concerning the clinical impact of renal artery revascularization. Despite the absence of sufficient randomized studies there is nonetheless evidence that stenting of hemodynamically relevant atherosclerotic renal artery stenosis has an impact on blood pressure control, renal function, and left ventricular hypertrophy.

scholarly journals Factors Associated with Outcomes of Percutaneous Transluminal Renal Angioplasty in Patients with Renal Artery Stenosis: A Retrospective Analysis of 50 Consecutive Cases

2018 ◽  
Vol 2018 ◽  
pp. 1-8 ◽  
Author(s):  
Tetsutaro Matayoshi ◽  
Kei Kamide ◽  
Ryoichi Tanaka ◽  
Tetsuya Fukuda ◽  
Takeshi Horio ◽  
...  
Keyword(s):  
Renal Function ◽  
Renal Artery ◽  
Renal Artery Stenosis ◽  
Resistive Index ◽  
Artery Stenosis ◽  
Renal Angioplasty ◽  
Factors Associated ◽  
Percutaneous Transluminal Renal Angioplasty ◽  
Takayasu Disease ◽  
Percutaneous Transluminal

Background. The results of recent trials have brought some confusion to the treatment strategy for renal artery stenosis (RAS). To evaluate the applicability of percutaneous transluminal renal angioplasty (PTRA) for RAS, we extracted the factors that may affect the effectiveness of PTRA from cases experienced at a hypertension center. Methods and Results. We retrospectively assessed the blood pressure (BP) lowering effects and renoprotective effects in 50 consecutive patients that had hemodynamically significant RAS and had undergone PTRA and stenting during 2001–2005. Subjects were diagnosed with atherosclerotic RAS (42), fibromuscular dysplasia (6), or Takayasu disease (2). After PTRA, BP significantly lowered from 152.3/80.3 mmHg to 132.6/73.2 mmHg (p<0.05), but the estimated glomerular filtration rate (eGFR) did not change significantly. There were no factors associated with the BP lowering effects of PTRA. The baseline resistive index (RI) was negatively correlated with the change in eGFR (p<0.05). After correction for age, sex, BMI, and the dose of contrast medium, the association of RI with change in eGFR remained significant. Conclusion. In cases with hemodynamically significant RAS, PTRA lowered BP but was not effective in improving renal function. Higher baseline RI may be a factor for predicting poor clinical course of renal function after PTRA.

scholarly journals Endovascular management of renal artery stenosis in renal transplantation

2020 ◽  
Vol 3 (2) ◽  
Author(s):  
Maria Peaire Lores
Keyword(s):  
Renal Function ◽  
Renal Artery ◽  
Renal Artery Stenosis ◽  
Stent Placement ◽  
Artery Stenosis ◽  
Endovascular Management ◽  
Renal Angioplasty ◽  
Allograft Dysfunction ◽  
Percutaneous Transluminal Renal Angioplasty ◽  
Percutaneous Transluminal

INTRODUCTION: Transplant renal artery stenosis is a recognized complication of kidney transplantation associated with allograft dysfunction and even graft loss. It is a commonly missed but potentially treatable complication that may present from months to years after transplant surgery. Its prompt diagnosis and adequate therapeutic management are essential to avoid renal function loss. MATERIAL AND METHODS: We retrospectively analysed the data from two 72-year-old patients transplanted in 2017 at our institution. Both with arterial hypertension, chronic ischemic heart disease and end-stage renal disease due to nephroangiosclerosis and membranous glomerulonephritis, respectively; presented allograft dysfunction in the immediate postoperative period. With this finding and the evidence of peak systolic velocity of >200 cm/s in the transplant renal artery we suspected transplant renal artery stenosis, confirmed by angiography and CT scan. An endovascular management with stent placement was performed. RESULTS: Both patients were managed by percutaneous transluminal renal angioplasty and stent placement with good morphological outcomes. After the procedure both patients presented a progressive renal function improvement, being discharged after 8 and 11 days, respectively. Since then, both patients have remained with stable renal function, presenting a glomerular filtration rate of 67 mL/min/1.73m2 and 60 mL/min/1.73m2 12 months after the surgery. No complications have been noticed after 14 months. CONCLUSION: Percutaneous transluminal renal angioplasty and stent placement is an effective and safe technique. Nevertheless, high experience is mandatory to reduce the number of complications and optimize the results of this technique.

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