Clinical characteristics of ischaemic renal disease

Abstract

Background. Longer life expectancy has favoured the ever more frequent development of ischaemic nephropathy characterized by the presence of atherosclerotic stenosis in both renal arteries. Methods. This is an observational and multicentre study carried out during a 14-month follow-up period in 20 hospitals in Spain. Inclusion criteria were the presence of bilateral renal artery stenosis > 50% and a creatinine level of ≥ 1.5 mg/dl. The diagnosis should be made by arterial digital angiography in every case. Results. A total of 156 patients were included. Their mean age was 68.7 ± 9 years, and 78.5% were male. The mean creatinine value of the group was 2.9 ± 1.7 mg/dl. Arterial hypertension (BP) with a duration of 12 ± 9 years was present in 97.4% of the cases, smoking habits in 69.8%, hypercholesterolaemia (≥ 240 mg/dl) in 62.9% and diabetes in 32.1%. Only 8% of the patients had a body mass index ≥ 30 kg/m2. Associated cardiovascular disease was very frequent: peripheral arteriopathy in 67.5% of the cases, ischaemic cardiopathy in 44.8%, cardiac insufficiency in 32.6% and stroke in 27.3%. In 94.4% of the patients, the lesion affected both renal arteries, with complete obstruction in 23% of the cases. Conclusions: Diagnostic suspicion of ischaemic nephropathy can be established in non-obese elderly males with chronic renal insufficiency, long-term BP evolution and cardiovascular disease at other levels, above all, peripheral arteriopathy.