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Progression of atherosclerotic renovascular disease: A prospective population-based study.

Progression of atherosclerotic renovascular disease: A prospective population-based study. Research Abstract Details 

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  • Progression of atherosclerotic renovascular disease: A prospective population-based study. Abstract Text:

    jeffrey d pearceJeffrey D Pearce,brandon l cravenBrandon L Craven,timothy e cravenTimothy E Craven,k todd piercyK Todd Piercy,jeanette m staffordJeanette M Stafford,matthew s edwardsMatthew S Edwards,kimberley j hansenKimberley J Hansen,

    OBJECTIVE: Previous reports from select hypertensive patients suggest that atherosclerotic renovascular disease (RVD) is rapidly progressive and associated with a decline in kidney size and kidney function. This prospective, population-based study estimates the incidence of new RVD and progression of established RVD among elderly, free-living participants in the Cardiovascular Health Study (CHS). METHOD: The CHS is a multicenter, longitudinal cohort study of cardiovascular risk factors, morbidity, and mortality among men and women aged >65 years old. From 1995 through 1996, 834 participants underwent renal duplex sonography (RDS) to define the presence or absence of significant RVD. Between 2002 and 2005, a second RDS study was performed in 119 participants (mean study interval, 8.0 +/- 0.8 years). Significant RVD was defined as hemodynamically significant stenosis (renal artery peak systolic velocity [RA-PSV] exceeding 1.8 m/s) or renal artery occlusion. Prevalent RVD was significant RVD at the first RDS, and incident disease was defined as new significant RVD at the second RDS. Significant change of RVD was defined as a change in RA-PSV of greater than two times the standard deviation of expected change over time, regardless of hemodynamic significance or progression to renal artery occlusion. RESULTS: The second RDS study cohort included 119 CHS participants with 235 kidneys (35% men; mean age, 82.8 +/- 3.4). On follow-up, no prevalent RVD (n = 13 kidneys; 6.0%) progressed to occlusion. Twenty-nine kidneys without RVD at the first RDS demonstrated significant change in PSV at the second RDS; including nine kidneys with new significant RVD (8 new stenoses; 1 new occlusion). Controlling for within-subject correlation, the overall estimated change in RVD among all 235 kidneys was 14.0% (95% confidence interval [CI], 9.2% to 21.4%), with progression to significant RVD in 4.0% (95% CI, 1.9% to 8.2%). Longitudinal increase in diastolic blood pressure and decrease in renal length were significantly associated with progression to new (ie, incident) significant RVD but not prevalent RVD. CONCLUSIONS: This is the first prospective, population-based estimate of incident RVD and progression of prevalent RVD among free-living elderly Americans. In contrast to previous reports among select hypertensive patients, CHS participants with a low rate of clinical hypertension demonstrated a significant change of RVD in only 14.0% of kidneys on follow-up of 8 years (annualized rate, 1.3% per year). Progression to significant RVD was observed in only 4.0% (annualized rate, 0.5% per year), and no prevalent RVD progressed to occlusion.

    Progression of atherosclerotic renovascular disease: A prospective population-based study. Publishing Authors By Initials

    jd pearceJD Pearce,bl cravenBL Craven,te cravenTE Craven,kt piercyKT Piercy,jm staffordJM Stafford,ms edwardsMS Edwards,kj hansenKJ Hansen,

    For similar diagnosis: diagnostic techniques and procedures: diagnostic imaging: ultrasonography: ultrasonography, doppler: ultrasonography, doppler, duplex research abstracts see: diagnosis: diagnostic techniques and procedures: diagnostic imaging: ultrasonography: ultrasonography, doppler: ultrasonography, doppler, duplex research

    PUBMED ID PMID:

    MEDLINE DATE:

    Progression of atherosclerotic renovascular disease: A prospective population-based study. Journal Published:

    PUBLICATION TYPE: Research Support, N.I.H., Extr

    Journal: Journal of vascular surgery : official publication

    VOLUME: 44

    Page Numbers: 955-62; discussion 962-3

    Journal Abbreviation: J. Vasc. Surg.

    ISSN: 0741-5214

    DAY: 18

    MONTH: 09

    YEAR: 2006

    Progression of atherosclerotic renovascular disease: A prospective population-based study. Information

    Number of References:

    LANGUAGE: eng

    NlmUniqueID: 8407742

    Progression of atherosclerotic renovascular disease: A prospective population-based study. Keywords Mesh Terms:

    KEYWORDS: Ultrasonography, Doppler, Duplex

    MESH TERMS: ultrasonography

    Chemical & Substance for Abstract: Progression of atherosclerotic renovascular disease: A prospective population-based study. Information

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    Grant and Affiliation Information for Progression of atherosclerotic renovascular disease: A prospective population-based study.

    AFFILIATION: Division of Surgical Sciences, Section on Vascular and Endovascular Surgery, Winston-Salem, North Carolina 27157-1095, USA.

    Country: United States

    United States Research PublicationUnited States Research Publication

    AGENCY: United States NHLBI

    GRANT: N01-HC-85086

    ACRONYM: HC

    MEDLINETA: J Vasc Surg

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