Authors: Scott Robert L Mehra Mandeep R Park Myung H Ventura Hector O Uber Patricia A
Publish Date: 2005/05/01
Volume: 18, Issue: S4, Pages: 135A-135A
Abstract
Robert L Scott Mandeep R Mehra Myung H Park Hector O Ventura Patricia A Uber P357 Incidental renal artery stenosis in heart transplantation Prevalence and clinical implications American Journal of Hypertension Volume 18 Issue S4 May 2005 Page 135A https//doiorg/101016/jamjhyper200503375Coronary angiography and concomitant renal artery angiography was performed in 58 consecutive cardiac transplant recipients ≥1year post transplantation who were then followed for at least 2 to 4 years Renal artery stenosis was defined as 50 lumen narrowing along with 10 mmHg gradient across the stenosis Associated cardiovascular risk factors such as diabetes age sex baseline cyclosporine and tacrolimus levels and allograft vasculopathy were evaluated Serial measurements of total cholesterol LDLcholesterol HDLcholesterol serum triglyceride and serum creatinine were also obtainedNine of 58 patients 155 met the criteria for renal artery stenosis in our cohort There was no significant difference in the presence of coronary allograft vasculopathy mean arterial blood pressure baseline serum creatinine or diabetes between the patients with renal artery stenosis +RAS and those without renal artery stenosis RAS The +RAS patients had significantly higher baseline levels totalcholesterol LDLcholesterol and Triglyceride Four of the 9 RAS patients underwent successful renal artery stenting No difference in 1 and 2 year mean arterial pressures or serum creatinine between the +RAS patients treated with conventional therapy versus stenting was noted Furthermore the utilization of health care resources in the inpatient setting as well as outpatient clinic resources were the same between the –RAS and +RAS patientsDespite the relatively high prevalence of incidental renal artery stenosis in heart transplantation no convincing adverse impact on either health resource use or long term renal function was demonstrated Thus the routine performance of renal angiography during surveillance coronary catheterization in heart transplantation cannot be justified
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