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Systematic Review

Prevalence and Risk Factors of Renal Artery Stenosis in Patients Undergoing Simultaneous Coronary and Renal Artery Angiography: A Systematic Review and Meta-Analysis of 31,689 Patients from 31 Studies

by
Konstantin Schwarz
1,
Ida Straume Bah
2,
Maximilian Will
1,3,
Chun Shing Kwok
4,
Julia Mascherbauer
1,
Marko Kumric
2,
Josko Bozic
2 and
Josip A. Borovac
2,5,*
1
Department of Internal Medicine 3, University Hospital St. Pölten, Karl Landsteiner University of Health Sciences, 3500 Krems, Austria
2
Department of Pathophysiology, University of Split School of Medicine (USSM), 21000 Split, Croatia
3
Karl Landsteiner Institute for Cardiometabolics, Karl Landsteiner Society, 3500 St. Poelten, Austria
4
Department of Cardiology, Leighton Hospital, Mid Cheshire Hospitals NHS Foundation Trust, Crewe CW1 4QJ, UK
5
Division of Interventional Cardiology, Cardiovascular Diseases Department, University Hospital of Split, 21000 Split, Croatia
*
Author to whom correspondence should be addressed.
Diseases 2024, 12(9), 208; https://doi.org/10.3390/diseases12090208
Submission received: 14 August 2024 / Revised: 31 August 2024 / Accepted: 9 September 2024 / Published: 11 September 2024
(This article belongs to the Section Cardiology)
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Abstract

Background/Objectives: Renal artery stenosis (RAS) is associated with coronary artery disease (CAD), exacerbation of arterial hypertension, and progression to heart failure, but remains frequently unrecognized in clinical practice. Methods: We conducted a systematic review and meta-analysis of studies by pooling data of patients undergoing CAG due to suspected or stable CAD that received a bilateral renal artery angiography. Results: A total of 31 studies with 31,689 patients were included (mean age 63.2 ± 8.7 years, 20.9% were female). Overall, 13.4% (95%CI 10.5–16.7%) of patients undergoing coronary angiography had significant RAS, with 6.5% (95% CI 4.5–8.9%) and 3.7% (95%CI 2.5–5.2%) having severe and bilateral RAS. The mean weighted proportion of patients with three-vessel coronary disease (3VD) was 25.1 (95%CI 19.6–30.9%) while 4.2% (95%CI 2.6–6.2%) had left main (LM) coronary disease. Patients with RAS compared to those without RAS were significantly older (mean difference, MD 4.2 years (95%CI 3.8–4.6)). The relative risk of RAS was greater for the female sex (risk ratio, 95%CI; RR 1.3, 1.03–1.57), presence of diabetes (RR 1.2, 1.10–1.36), arterial hypertension (RR 1.3, 1.21–1.46), dyslipidemia (RR 1.1, 1.06–1.14), peripheral artery disease (PAD) (RR 2.1, 1.40–3.16), chronic kidney disease (CKD) (RR 2.6, 2.04–3.37), 3VD (RR 1.6, 1.30–1.87), and LM disease (RR 1.8, 1.28–2.47). Smoking had a neutral effect on the risk of RAS occurrence (RR 1.0, 0.94–1.06). Conclusions: RAS is common in patients undergoing coronary angiography. CKD, PAD, older age, and severe CAD were among the strongest predictors for the presence of significant RAS.
Keywords: coronary artery disease; coronary angiography; prevalence; renal artery stenosis; risk factors coronary artery disease; coronary angiography; prevalence; renal artery stenosis; risk factors

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MDPI and ACS Style

Schwarz, K.; Straume Bah, I.; Will, M.; Kwok, C.S.; Mascherbauer, J.; Kumric, M.; Bozic, J.; Borovac, J.A. Prevalence and Risk Factors of Renal Artery Stenosis in Patients Undergoing Simultaneous Coronary and Renal Artery Angiography: A Systematic Review and Meta-Analysis of 31,689 Patients from 31 Studies. Diseases 2024, 12, 208. https://doi.org/10.3390/diseases12090208

AMA Style

Schwarz K, Straume Bah I, Will M, Kwok CS, Mascherbauer J, Kumric M, Bozic J, Borovac JA. Prevalence and Risk Factors of Renal Artery Stenosis in Patients Undergoing Simultaneous Coronary and Renal Artery Angiography: A Systematic Review and Meta-Analysis of 31,689 Patients from 31 Studies. Diseases. 2024; 12(9):208. https://doi.org/10.3390/diseases12090208

Chicago/Turabian Style

Schwarz, Konstantin, Ida Straume Bah, Maximilian Will, Chun Shing Kwok, Julia Mascherbauer, Marko Kumric, Josko Bozic, and Josip A. Borovac. 2024. "Prevalence and Risk Factors of Renal Artery Stenosis in Patients Undergoing Simultaneous Coronary and Renal Artery Angiography: A Systematic Review and Meta-Analysis of 31,689 Patients from 31 Studies" Diseases 12, no. 9: 208. https://doi.org/10.3390/diseases12090208

APA Style

Schwarz, K., Straume Bah, I., Will, M., Kwok, C. S., Mascherbauer, J., Kumric, M., Bozic, J., & Borovac, J. A. (2024). Prevalence and Risk Factors of Renal Artery Stenosis in Patients Undergoing Simultaneous Coronary and Renal Artery Angiography: A Systematic Review and Meta-Analysis of 31,689 Patients from 31 Studies. Diseases, 12(9), 208. https://doi.org/10.3390/diseases12090208

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