NATURAL HISTORY OF RENAL ARTERY STENOSIS

描述：(改编自《调查者摘要》)肾动脉 狭窄是高血压和肾功能衰竭的重要原因。这个 导致肾动脉狭窄的最常见的疾病过程是 动脉硬化。肾动脉病变的无创性检测 一直是一个难题，直到最近，侵入性动脉造影术 是唯一可靠的方法。然而，在过去的几年里， 超声双工扫描已经成为一种准确的 筛查被认为有肾动脉风险的患者 疾病。此外，同样的非侵入性方法可用于 对这些患者进行连续随访，以记录在 肾动脉随时间的变化。 一个从未得到严格解决的重要问题是 肾动脉损害的自然病史。目前尚不清楚 肾动脉狭窄有可能进展，发生率是多少 进展可能是，肾动脉闭塞是否是一种 可能性很大。肾功能和肾质量状况 合并肾动脉狭窄也是重要的考虑因素。 据估计，每年将有多达10万名患者 进行性双侧肾动脉继发缺血性肾功能衰竭 动脉硬化。调查人员指出，如果风险和利率 可以定义肾动脉的疾病进展，它将 是一项重大成就，可能对 病人管理。 拟议的项目将在#年启动长期后续研究。 有记录的肾动脉狭窄的患者。这将是 通过使用双面扫描，每隔6至12个月完成。 肾动脉的状况、肾大小、肾功能和 高血压患者血压控制及危险因素的临床资料 将对动脉粥样硬化进行监测。这些数据将被分析以 确定肾动脉疾病的进展率和 作为疾病进展预测因子的特定临床变量。这个 观察到的肾动脉疾病严重程度的变化也将 与动脉闭塞性疾病的严重程度相关 颈动脉和下肢循环。

DESCRIPTION: (Adapted from Investigator's Abstract) Renal artery stenosis is an important cause of hypertension and renal failure. The most common disease process that results in renal artery stenosis is atherosclerosis. Detection of renal artery lesions by noninvasive means has been a difficult problem, and until recently invasive arteriography was the only reliable method. However, during the past few years, ultrasonic duplex scanning has emerged as an accurate technique for screening patients who are considered to be at risk for renal artery disease. In addition, this same noninvasive approach can be used for serial follow-up of these patients to document the changes that occur in the renal arteries over time. An important issue which has never been rigorously addressed is the natural history of renal artery lesions. It is currently unknown whether renal artery stenoses are likely to progress, what the rate of progression might be, and whether renal artery occlusion is a significant possibility. The status of renal function and renal mass associated with renal artery stenosis are also important considerations. It is estimated that up to 100,000 patients per year will develop ischemic renal failure secondary to progressive bilateral renal artery atherosclerosis. The investigators point out that if the risk and rate of disease progression in the renal arteries could be defined, it would be a major accomplishment that could have significant implications for patient management. The proposed project will initiate long-term follow-up studies in patients with documented renal artery stenosis. This will be accomplished by the use of duplex scanning at 6 to 12 month intervals. The status of the renal arteries, renal size, renal function, and clinical data regarding blood pressure control and risk factors for atherosclerosis will be monitored. These data will be analyzed to determine the rate of renal artery disease progression and the value of specific clinical variables as predictors of disease progression. The observed changes in renal artery disease severity will also be correlated with the severity of arterial occlusive disease in the carotid and lower extremity circulations.