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Study questions need for routine intervention in patients with renovascular disease
Date:10/13/2009

ic indications, not just for all patients whose ultrasound reports confirm the presence of artery narrowing. There need to be other indicators of progressive renovascular disease present to consider subjecting patients to the risks and costs of these procedures."

The study appears in the September issue of the Journal of Vascular Surgery, the peer-reviewed publication of the Society for Vascular Surgery.

For the study, researchers reviewed the medical records of 434 hypertensive patients who received at least two renal artery ultrasounds from October 1993 through July 2008 to determine whether they had renal artery stenosis. Patients referred for renal artery ultrasound typically have blood pressure that has grown more difficult to control or have declining kidney function.

The researchers found that, of the 863 kidneys examined, 178 just over 20 percent showed significant stenosis, or narrowing of the renal arteries, at the time of the patients' initial ultrasounds. During follow up, however, only 72 kidneys showed progression of the disease, with only two percent 18 of the original 863 progressing to occlusion, or blockage of one or both of the renal arteries. In addition, the researchers found that progression of the arterial stenosis did not always predict a severe decline of kidney function.

Currently, patients who undergo renal artery ultrasound and are found to have renal artery stenosis may be recommended for surgical bypass or angioplasty with stenting to reinforce and hold open narrowed walls and ultimately, prevent complete blockage of the renal arteries, which may cause kidney failure, among other things. These recommendations have proven of value in the presence of severe hypertension and declining kidney function, but not in the absence of these indications.

Over the last several years, detection of renal artery stenosis has grown easier as technology has improved and become more widely available
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Contact: Jessica Guenzel
jguenzel@wfubmc.edu
336-716-3487
Wake Forest University Baptist Medical Center
Source:Eurekalert

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