The prevalence and associated risk factors of renal artery stenosis in patients undergoing cardiac catheterization

Renal artery stenosis may be a cause of hypertension and a potential contri butor to progressive renal insufficiency. However, the prevalence of renal artery disease in a general population is poorly defined. The purposes of t his study were to evaluate the prevalence of angiographically-determined re nal artery narrowing in a patient population undergoing routine cardiac cat heterization, and to identify the risk factors for renal artery stenosis. A fter left ventriculography, abdominal aortography was performed to screen f or the presence of renal artery stenosis. A total of 427 patients (274 male s, 153 females) were studied and the mean age was 59 years. Renal artery na rrowing was identified in 10.5% of patients. Significant (greater than or e qual to 50% diameter narrowing) renal artery stenosis was found in 24 patie nts (5.6%) and insignificant stenosis was found in 21 patients (4.9%). Sign ificant unilateral stenosis was present in 4.2% of patients and bilateral s tenosis was present in 1.4%. The stem of the renal artery was a more common site of stenosis in 62.2% of patients than in the ostium (37.8%), but the severity of stenosis was not significantly different according to the sire of stenosis. By univariate and multivariate logistic regression analysis, t he association of clinical variables with renal artery stenosis was assesse d. Multivariable predictors included age, hypertension and peripheral vascu lar disease (p<0.05). The variables such as sex, smoking history, hyperlipi demia, renal insufficiency, as well as the presence of obesity, severity of coronary heart disease and D.M., were not associated. In conclusion, the p revalence of angiographically-determined renal artery narrowing in a patien t population undergoing cardiac catheterization is 10.5%. Old age, hyperten sion and evidence of peripheral vascular disease represent the predictors o f renal artery stenosis.