Background: Atherosclerotic renovascular disease isassociated with resistant hypertension and chronic kidneydisease, although the causal relationship is discussed. Todate, the role of renal artery diameter on thesepathological conditions was not clearly studied. We aimedto identify the association of reference diameter andminimal luminal renal artery diameter with glomerularfiltration rate (GFR) and resistant hypertension in a highcardiovascular risk population.Methods: In this cross-sectional, single-center study, weenrolled 734 patients who underwent a renal angiographyimmediately after a coronary angiography indicated for adiagnosis of ischemic heart disease.Results: Mean age was 6410 years (men 72%). GFRwas 7922 ml/min per 1.73m2. Five hundred andeighteen patients had no luminal narrowing and 216patients had low-to-moderate luminal narrowing (10–70%, mean 36%). A positive significant associationbetween reference diameter and GFR was detected inpatients without luminal narrowing [beta 2.2 ml/min per1.73m2 for 1mm increase, 95% confidence interval (CI)0.3–4.0, P<0.05] and in those with low-to-moderateluminal narrowing (beta 7.7 ml/min per 1.73m2 for 1mmincrease, 95% CI 4.2–11.1, P<0.001). The lowest quartileof reference diameter (<5.2mm) was associated with GFRless than 60 ml/min per 1.73m2 [odds ratio (OR) 3.18,95% CI 1.61–6.29, P<0.001]. Patients with resistanthypertension had low minimal diameter and referencediameter. Reference diameter less than 5.2mm wasassociated with an increased risk of resistant hypertension(OR 2.63, 95% CI 1.02–6.77, P<0.05).Conclusions: Small renal arteries, defined by a lowreference diameter or minimal luminal diameter, areindependently associated with low GFR and resistanthypertension, independent of the degree of stenosis andmajor confounders.

Renal artery diameter, renal function and resistant hypertension in patients with low-to-moderate renal artery stenosis

Zanoli L;TAMBURINO, Corrado;CASTELLINO, Pietro
2012-01-01

Abstract

Background: Atherosclerotic renovascular disease isassociated with resistant hypertension and chronic kidneydisease, although the causal relationship is discussed. Todate, the role of renal artery diameter on thesepathological conditions was not clearly studied. We aimedto identify the association of reference diameter andminimal luminal renal artery diameter with glomerularfiltration rate (GFR) and resistant hypertension in a highcardiovascular risk population.Methods: In this cross-sectional, single-center study, weenrolled 734 patients who underwent a renal angiographyimmediately after a coronary angiography indicated for adiagnosis of ischemic heart disease.Results: Mean age was 6410 years (men 72%). GFRwas 7922 ml/min per 1.73m2. Five hundred andeighteen patients had no luminal narrowing and 216patients had low-to-moderate luminal narrowing (10–70%, mean 36%). A positive significant associationbetween reference diameter and GFR was detected inpatients without luminal narrowing [beta 2.2 ml/min per1.73m2 for 1mm increase, 95% confidence interval (CI)0.3–4.0, P<0.05] and in those with low-to-moderateluminal narrowing (beta 7.7 ml/min per 1.73m2 for 1mmincrease, 95% CI 4.2–11.1, P<0.001). The lowest quartileof reference diameter (<5.2mm) was associated with GFRless than 60 ml/min per 1.73m2 [odds ratio (OR) 3.18,95% CI 1.61–6.29, P<0.001]. Patients with resistanthypertension had low minimal diameter and referencediameter. Reference diameter less than 5.2mm wasassociated with an increased risk of resistant hypertension(OR 2.63, 95% CI 1.02–6.77, P<0.05).Conclusions: Small renal arteries, defined by a lowreference diameter or minimal luminal diameter, areindependently associated with low GFR and resistanthypertension, independent of the degree of stenosis andmajor confounders.
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/20.500.11769/11762
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