Renal artery stenosis epidemiology and demographics
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Epidemiology and demographics
Renal artery stenosis considered a disease of the elderly.[1] It most commonly affects patients with cardiovascular co-morbidities, such as those with diabetes mellitus, coronary and peripheral artery disease, dyslipidemia, essential hypertension, and smoking history.[2][3][4][5] It is difficult to assess the real incidence and prevalence of renal artery stenosis because most patients with the disease are in fact asymptomatic. As such, the disease prevalence is underestimated.[6] In a study that involved 14,152 patients undergoing abdominal aortography, approximately 10% of the patients had RAS and 1.3% had bilateral RAS, 60% of which were considered significant stenoses.[5] Autopsy findings among 5194 patients between 1980 and 1988 showed that 4.3% of all patients RAS, most of which were not diagnosed.[2] The frequency of RAS among patients with diabetes and hypertension was higher, reaching up to 10% of all patients. [2] Bilateral renal artery stenosis was higher in diabetic patients, but significant association was not reached in the study.[2]
Atherosclerotic renal artery stenosis affects approximately 0.5-7% of the U.S. population above the age of 65 years. It is present in almost 5% of patients with chronic kidney disease.( 15954920, 12218965) Although stenosis may progress in 30-53% of patients within only 2-5 years after diagnosis, only 3-15% of patient with ARAS progress to total occlusion of the renal arteries.[4][3][4][7][8] The definition of disease progression, however, may vary between individual studies.
To date, there is no reliable information about the prevalence of secondary hypertension due to renal artery stenosis. Follow-up and prognosis for hypertensive patients with renal artery stenosis has not yet been achieved.
References
- ↑ Safian RD, Textor SC (2001). "Renal-artery stenosis". N Engl J Med. 344 (6): 431–42. doi:10.1056/NEJM200102083440607. PMID 11172181.
- ↑ 2.0 2.1 2.2 2.3 Sawicki PT, Kaiser S, Heinemann L, Frenzel H, Berger M (1991). "Prevalence of renal artery stenosis in diabetes mellitus--an autopsy study". J Intern Med. 229 (6): 489–92. PMID 2045754.
- ↑ 3.0 3.1 Dean RH, Kieffer RW, Smith BM, Oates JA, Nadeau JH, Hollifield JW; et al. (1981). "Renovascular hypertension: anatomic and renal function changes during drug therapy". Arch Surg. 116 (11): 1408–15. PMID 7305653.
- ↑ 4.0 4.1 4.2 Tollefson DF, Ernst CB (1991). "Natural history of atherosclerotic renal artery stenosis associated with aortic disease". J Vasc Surg. 14 (3): 327–31. PMID 1880841.
- ↑ 5.0 5.1 Crowley JJ, Santos RM, Peter RH, Puma JA, Schwab SJ, Phillips HR; et al. (1998). "Progression of renal artery stenosis in patients undergoing cardiac catheterization". Am Heart J. 136 (5): 913–8. PMID 9812088.
- ↑ Dworkin LD, Cooper CJ (2009). "Clinical practice. Renal-artery stenosis". N Engl J Med. 361 (20): 1972–8. doi:10.1056/NEJMcp0809200. PMID 19907044.
- ↑ Caps MT, Zierler RE, Polissar NL, Bergelin RO, Beach KW, Cantwell-Gab K; et al. (1998). "Risk of atrophy in kidneys with atherosclerotic renal artery stenosis". Kidney Int. 53 (3): 735–42. doi:10.1046/j.1523-1755.1998.00805.x. PMID 9507221.
- ↑ Caps MT, Perissinotto C, Zierler RE, Polissar NL, Bergelin RO, Tullis MJ; et al. (1998). "Prospective study of atherosclerotic disease progression in the renal artery". Circulation. 98 (25): 2866–72. PMID 9860789.