This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Kuroda, S. Articles by Kimura, G. Search for Related Content PubMed PubMed Citation Articles by Kuroda, S. Articles by Kimura, G.

(Stroke. 2000;31:61.)
© 2000 American Heart Association, Inc.

Original Contributions

Prevalence of Renal Artery Stenosis in Autopsy Patients With Stroke

Setsuko Kuroda, MD; Naoki Nishida, MD; Takashi Uzu, MD; Masanobu Takeji, MD; Masataka Nishimura, MD; Takashi Fujii, MD; Satoko Nakamura, MD; Takashi Inenaga, MD; Chikao Yutani, MD Genjiro Kimura, MD

From the Divisions of Nephrology (S.K., T.U., M.T., M.N., T.F., S.N., T.I., G.K.) and Pathology (N.N., C.Y.), National Cardiovascular Center, Osaka, Japan.

Background and Purpose—Atherosclerotic renal artery stenosis commonly exists as one manifestation of more generalized atherosclerosis. It is a progressive but potentially curable disorder. Thus, information on renal artery involvement in atherosclerotic diseases could be important. We investigated the prevalence of renal artery stenosis in autopsied patients with stroke over 40 years of age.

Methods—From 2167 consecutive autopsy patients who died between 1980 and 1997, we studied 346 cases of mean age of 69±11 years with clinical evidence of stroke.

Results—Atherosclerotic renal artery stenosis (75% luminal area narrowing) was found in 36 patients (10.4%). Patients with renal artery stenosis were older and had worse renal function. Renal artery stenosis was found in 14.7%, 28.6%, and 23.9% of patients with hypertension, renal insufficiency, and aortic aneurysm, respectively. Extracranial carotid artery stenosis (>50% luminal area narrowing) was found in 101 patients (29.2%). Of the 346 stroke patients, 256 had a history of brain infarction. In patients with brain infarction, renal artery stenosis was found in 31 (12.1%) and carotid stenosis was found in 81 (33.6%). Patients with carotid artery stenosis were more likely to have renal artery stenosis than patients without carotid artery stenosis (24.4% versus 5.9%, P<0.0001). Multiple logistic regression analysis identified renal insufficiency, hypertension, female gender, and presence of carotid artery stenosis as independent predictors of renal artery stenosis in patients with brain infarction.

Conclusions—These data reveal that atherosclerotic renal artery stenosis is common in patients with stroke, especially in those with brain infarction.

Key Words: autopsy • hypertension • carotid stenosis • renal artery • stroke

This article has been cited by other articles:

				G. Tsagalis, T. Akrivos, M. Alevizaki, E. Manios, K. Stamatellopoulos, A. Laggouranis, and K. N. Vemmos Renal dysfunction in acute stroke: an independent predictor of long-term all combined vascular events and overall mortality Nephrol. Dial. Transplant., August 26, 2008; (2008) gfn471v1. [Abstract] [Full Text] [PDF]

				T. K. Alphons Wierema, A. A. Kroon, and P. W. de Leeuw Poor performance of diagnostic tests for atherosclerotic renal artery stenosis--discrepancies between stenosis and renal function Nephrol. Dial. Transplant., March 1, 2007; 22(3): 689 - 692. [Full Text] [PDF]

				H. Guo, P. A. Kalra, D. T. Gilbertson, J. Liu, S.-C. Chen, A. J. Collins, and R. N. Foley Atherosclerotic Renovascular Disease in Older US Patients Starting Dialysis, 1996 to 2001 Circulation, January 2, 2007; 115(1): 50 - 58. [Abstract] [Full Text] [PDF]

				M. A Allison, D. DiTomasso, M. H Criqui, R. D Langer, and C M. Wright Renal artery calcium: relationship to systemic calcified atherosclerosis Vascular Medicine, November 1, 2006; 11(4): 232 - 238. [Abstract] [PDF]

				M. Chonchol and S. Linas Diagnosis and Management of Ischemic Nephropathy Clin. J. Am. Soc. Nephrol., March 1, 2006; 1(2): 172 - 181. [Full Text] [PDF]

				H. Fujii, S. Nakamura, S. Kuroda, F. Yoshihara, H. Nakahama, T. Inenaga, H. Ueda-Ishibashi, C. Yutani, and Y. Kawano Relationship between renal artery stenosis and intrarenal damage in autopsy subjects with stroke Nephrol. Dial. Transplant., January 1, 2006; 21(1): 113 - 119. [Abstract] [Full Text] [PDF]

				C. M. Cheung, J. Hegarty, and P. A. Kalra Dilemmas in the management of renal artery stenosis Br. Med. Bull., September 7, 2005; 73-74(1): 35 - 55. [Abstract] [Full Text] [PDF]

				R. de Silva, N. P. Nikitin, S. Bhandari, A. Nicholson, A. L. Clark, and J. G.F. Cleland Atherosclerotic renovascular disease in chronic heart failure: should we intervene? Eur. Heart J., August 2, 2005; 26(16): 1596 - 1605. [Abstract] [Full Text] [PDF]

				R. C. Pasternak, M. H. Criqui, E. J. Benjamin, F. G. R. Fowkes, E. M. Isselbacher, P. A. McCullough, P. A. Wolf, and Z.-J. Zheng Atherosclerotic Vascular Disease Conference: Writing Group I: Epidemiology Circulation, June 1, 2004; 109(21): 2605 - 2612. [Full Text] [PDF]

				C. E. Buller, J. G. Nogareda, K. Ramanathan, D. R. Ricci, O. Djurdjev, K. J. Tinckam, I. M. Penn, R. S. Fox, L. A. Stevens, J. A. Duncan, et al. The profile of cardiac patients with renal artery stenosis J. Am. Coll. Cardiol., May 5, 2004; 43(9): 1606 - 1613. [Abstract] [Full Text] [PDF]

				P.-F. PLOUIN, P. ROSSIGNOL, and G. BOBRIE Atherosclerotic Renal Artery Stenosis: To Treat Conservatively, to Dilate, to Stent, or to Operate? J. Am. Soc. Nephrol., October 1, 2001; 12(10): 2190 - 2196. [Full Text] [PDF]