国家神经系统疾病临床医学研究中心数据管理与共享系统
Data Management And Sharing System of China National Clinical Research Center for Neurological Diseases
2024-03-07
已发表文章
主要研究背景及目的
Renal artery atherosclerosis is considered to be one of the manifestations of generalized atherosclerosis. Atherosclerotic renal artery stenosis (ARAS) that develops on the basis of renal artery plaque (RAP), represents the leading cause of secondary hypertension, and may lead to resistant-hypertension, progressive decline in renal function, and cardiac destabilization syndromes. ARAS could also be associated with an increased risk of coronary heart disease and adverse cardiovascular outcomes. Up to now, the epidemiology of renal artery atherosclerosis has been poorly explored. The present study aimed to determine the prevalence of atherosclerotic plaque and stenosis in renal artery, and to estimate the association of plaque and stenosis with some traditional vascular risk factors and kidney disease markers.
方法
We conducted a cross-sectional analysis based on the baseline survey of the PRECISE study. In this study, we aimed to assess the prevalence of atherosclerotic plaque and stenosis in renal artery diagnosed by CTA. The presence of RAP was defined as structures of at least a 1-mm^2 area within or adjacent to the artery lumen and clearly distinguishable from the vessel lumen. For each territory, the area-based degree of narrowing was recorded for the most stenotic plaque. The presence of ARAS was defined as 50% to 99% stenosis or occlusion. Multivariate logistic regression analysis using stepwise forward methods was used for assessment of variables that were associated with RAP/ARAS.
结论
There was a non-negligible prevalence of atherosclerotic plaque and stenosis in the renal arteries among community-dwelling adults aged 50-75 years in China. Established vascular risk factors including older age, hypertension, and dyslipidemia, as well as indicators of kidney disease were independently associated with RAP or ARAS.
主要结果
RAP and ARAS were evaluated by thoracoabdominal computed tomography angiography. A total of 3,045 adults aged 50-75 years were included. The prevalence of RAP and ARAS was 28.7% and 4.8%, respectively. The prevalence of RAP and ARAS was 41.3% and 7.7% in individuals aged ≥60 years, 42.9% and 8.7% in hypertensives, and 45.4% and 8.5% in individuals with chronic kidney disease. Older age, hypertension, higher total cholesterol level, and lower high-density lipoprotein cholesterol level were independently associated with RAP and ARAS. A higher urinary albumin-creatinine ratio was independently associated with RAP, whereas a reduced estimated glomerular filtration rate was independently associated with ARAS.