NATURAL HISTORY OF RENAL ARTERY STENOSIS

描述：（改编自研究者摘要）肾动脉 狭窄是高血压和肾衰竭的重要原因。的 导致肾动脉狭窄的最常见的疾病过程是 动脉粥样硬化肾动脉病变的无创性检测 一直是个难题，直到最近， 是唯一可靠的方法。 然而，在过去的几年里， 超声双重扫描已经成为一种精确的技术， 筛查被认为有肾动脉风险的患者 疾病 此外，这种非侵入性方法也可用于 对这些患者进行系列随访，以记录 肾动脉的变化 一个从未得到严格解决的重要问题是 肾动脉病变的自然史。目前尚不清楚是否 肾动脉狭窄有可能进展， 进展可能是，以及肾动脉闭塞是否是 重大可能性。 肾功能和肾肿块的状态 与肾动脉狭窄相关的并发症也是重要的考虑因素。 据估计，每年将有多达10万名患者 进展性双侧肾动脉缺血性肾功能衰竭 动脉粥样硬化 研究人员指出，如果风险和利率 可以定义肾动脉疾病进展， 是一项重大成就，可能对 病人管理 建议的研究计划将于 记录肾动脉狭窄的患者。 这将是 每隔6至12个月使用双工扫描完成。 肾动脉的状态、肾脏大小、肾功能和 关于血压控制和风险因素的临床数据 将监测动脉粥样硬化。这些数据将被分析， 确定肾动脉疾病进展的速率和 特定临床变量作为疾病进展的预测因子。 的 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.