Objective: We have demonstrated a point prevalence of 26% renal artery stenosis in patients with antiphospholipid syndrome (APS) and uncontrolled hypertension. We describe the effect of anticoagulation on blood pressure control and renal function.
Methods: We studied 23 patients retrospectively with renal artery stenosis (RAS). Fourteen received oral anticoagulation for more than 1 yr (target International Normalized Ratio (INR) of 3.0-4.5). Five patients had primary APS. Patients were divided into two groups based on their INR (< 3.0 and > or = 3.0). Nine patients had repeat magnetic resonance angiography (MRA) or an angiogram of the renal arteries after 2 yr.
Results: Only 8/14 patients managed to maintain their INR > or = 3.0 (median INR 3.1, range 2.8-3.7) while six had a INR < 3.0 (median INR 1.9, range 1.2-2.4). Patients with a median INR < 3.0 had poorly controlled blood pressure and there was significant deterioration in mean serum creatinine values (Wilcoxon's test, P < 0.03). Nine patients underwent follow-up renal artery imaging. Three of nine patients with an INR < 3.0 (median INR 1.9) had re-stenosis and a fourth developed bilateral renal artery stenosis. Five patients with INR > or = 3.0 (median INR 3.1) did not show re-stenosis of the renal arteries; their renal function was stable and blood pressure was well controlled. One other patient with secondary APS (mixed connective tissue disorder) with INR > 3.0 showed recanalization of the stenosed renal artery.
Conclusion: Anticoagulation with INR maintained > or = 3.0 helped to control the blood pressure and prevent the progression of renal disease.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1093/rheumatology/keh490 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Randomised controlled feasibility trial of retroperitoneal vs transperitoneal robot-assisted partial nephrectomy: the ROPARN study.
BJU Int
January 2025
Department of Urology, St. Josef Medical Center, University of Regensburg, Regensburg, Germany.
Objectives: To assess the feasibility of trial recruitment and confirm that retroperitoneal robotic partial nephrectomy (RRPN) has the same oncological efficacy as transperitoneal robotic partial nephrectomy (TRPN), with time advantages and less peri-operative morbidity, in a randomised controlled trial (RCT).
Patients And Methods: The study was designed as a single-centre, open-label, feasibility RCT. Patients with suspected localised renal cell carcinoma referred for robotic partial nephrectomy were randomised in a 1:1 ratio to receive either TRPN or RRPN.
Computed tomography coronary angiography as an alternative to invasive coronary angiography in preoperative evaluation for mitral surgery.
J Thorac Cardiovasc Surg
January 2025
Mount Sinai Health System, New York, NY.
Objective: The aim of this study was to assess the effectiveness of non-invasive coronary computed tomography angiography (CTA) as an alternative to traditional invasive coronary angiography (ICA) for preoperative evaluation of low risk patients with an indication for non-emergent mitral surgery and to assess any difference in adverse outcomes from this strategy.
Methods: This was a retrospective cohort study from a single center with data collected from July 2014 - June 2020 for 1576 patients undergoing mitral valve surgery of all etiologies - excluding patients requiring coronary artery bypass surgery. We performed a 1:2 propensity score matching for patients evaluated with CT (n=345) to those evaluated with ICA (n=602).
Thirty-day stroke/mortality of carotid revascularization in asymptomatic patients with newly diagnosed and/or decompensated heart failure exceeds the Society for Vascular Society guideline risks.
J Vasc Surg
January 2025
The George Washington University Hospital, Department of Surgery, Washington, D.C., USA.
Background: According to the latest Society for Vascular Surgery (SVS) guidelines, carotid revascularization for asymptomatic individuals should be offered if the perioperative stroke/death rate does not exceed 3%. Heart failure (HF) has been associated with reduced survival rates following carotid revascularization, which may significantly impact the risk-benefit decision of treating asymptomatic patients with HF. This study aimed to evaluate the 30-day postoperative risks in asymptomatic patients with newly diagnosed and/or decompensated HF undergoing carotid endarterectomy (CEA) and carotid artery stenting (CAS).
View Article and Find Full Text PDFAneurysmal rupture in microscopic polyangiitis: a case-based review.
Clin Rheumatol
January 2025
Department of Medical Laboratory Science, Faculty of Health Sciences, Hokkaido University, Sapporo, Hokkaido, Japan.
Microscopic polyangiitis (MPA) affects small and medium vessel, which sometimes leads to arterial aneurysms. In English database, only 15 reports refer to ruptured aneurysms in MPA. We experienced a fatal case with MPA who developed multiple visceral aneurysms, resulting in rupture of the hepatic aneurysm.
View Article and Find Full Text PDFResistant Renovascular Hypertension in Youth: Fibromuscular Dysplasia or Takayasu Arteritis?
Am J Case Rep
January 2025
Department of Pediatrics and Nephrology, Medical University of Warsaw, Warsaw, Poland.
BACKGROUND Arterial hypertension in pediatric patients often presents complex diagnostic and therapeutic challenges. The diagnosis of hypertension in children is based on different guidelines than in adults, with arterial hypertension in children defined as systolic and/or diastolic blood pressure values at or above the 95th percentile for age, sex, and height. Unlike adult populations, it is predominantly secondary in etiology, with conditions such as renovascular hypertension as common causes.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!