A clinicopathologic evaluation of renal arterystenosis with abdominal aortic aneurysm

Abstract

Aims: Renal artery stenosis (RAS) and aortic aneurysm are becoming more common growing because of the increased mean age of the population and the greater prevalence of hypertensive and diabetic patients. Here we report on the clinical course of abdominal aortic aneurysm (AAA) associated with RAS, and analyze the laboratory data and pathological findings.
Patients and Methods: Thirty-eight operated patients and two treated conservatively were divided into twogroups, i.e., 10 patients with RAS and 30 without RAS. Then we observed the prognosis of five young patientswith renal artery fibromuscular dysplasia without AAA to clarify that of systemic atherosclerotic patients.
Results: Renal function had already declined before admission and rapidly decreased further after surgery in 7 of the 10 patients with RAS and their prognosis was very poor, particularly in the case of 3 patients with cholesterol crystal embolism. Two RAS patients suffered rupture of aneurysm while waiting for surgery on hemodialysis. Advanced ischemic changes were observed in the kidneys of RAS patients. Two patients with unilateral renal artery stenosis showed severe histologic changes of both kidneys.
Conclusion: The pathogenesis and symptoms of RAS with AAA are complex, and it is important to select adequate treatment for each patient, considering the systemic status carefully.