Prevalence of Renal Artery Stenosis Following Diagnostic Coronary Angiography

Renal artery atherosclerosis is the most common cause of renovascular hypertension and ischemic nephropathy which is potentially a correctable problem by surgery or intravascular intervention. The prevalence of Renal Artery Disease (RAD) in hypertensive patients evaluated for Coronary Artery Disease (CAD) as the main symptom of atherosclerosis, in our population is unknown, we began evaluation of renal artery stenosis in these patients. A prospective cross-sectional study carried out from March 2004 through January 2005 in cardiology department of Emam Reza Hospital, Mashhed University of Medical Sciences, Mashhad, Iran. Over all 255 of patients suspicious of CAD included in this study. Coronary angiography performed by femoral artery approach followed by renal artery angiography. Artery' involvement with more than 50% of the lumen (renal arteries or coronaries) classified as significant stenosis. Coronary stenosis divided into 1-, 2- or 3-vessel involvement. Collected data analyzed by SPSS. The patients were 129 males and 126 females, with the mean age of 58.5%+10.6. A total of 200 patients (mean age of 59.7±10.5) had CAD and the reminders had normal coronary arteries (mean age 61.5±10.3). The Prevalence of RAD in patients with CAD was 31% (63 patients; 19 bilateral and 44 unilateral stenosis), of significant RAD in 1-, 2-, or 3-vessel involvement were as follow respectively 24.27%, 35.7% and 36.5 %. In 55 patients with normal coronary arteries, the prevalence of RAD was 3.6% (p<0.001). Many studies have shown the progressive nature of renal artery stenosis; therefore, early diagnosis will prevent its progression and other consequences. Our results suggest that CAD, especially when more arteries are involved, is a predictor of renal artery stenosis. Since 31% of our hypertensive patients with CAD had significant renal artery stenosis, we recommend that renal artery angiography be performed following coronary angiography for those patients with significant stenosis.