Angiographic progression of coronary artery disease in patients with end‐stage renal disease

• Published in: Nephrology, dialysis, transplantation dialysis, transplantation, 2001-06, Vol.16 (6), p.1198-1202
• Main Authors: Gradaus, Frank, Ivens, Katrin, Peters, Ansgar J., Heering, Peter, Schoebel, Frank‐Chris, Grabensee, Bernd, Strauer, Bodo‐Eckehard
• Format: Article
• Language: English
• Subjects: Adult; Aged; angiography; Biological and medical sciences; cardiovascular mortality; Coronary Angiography; coronary artery disease; Coronary Disease - complications; Coronary Disease - diagnostic imaging; Coronary Disease - physiopathology; Diabetes Mellitus - epidemiology; Diabetic Angiopathies - epidemiology; Disease Progression; end‐stage renal disease; Female; Humans; Hyperlipidemias - epidemiology; Hypertension - epidemiology; Kidney Failure, Chronic - complications; Kidney Failure, Chronic - physiopathology; Kidney Failure, Chronic - therapy; Male; Medical sciences; Middle Aged; morphological progression; Nephrology. Urinary tract diseases; Nephropathies. Renovascular diseases. Renal failure; Peritoneal Dialysis, Continuous Ambulatory; Renal Dialysis; Renal failure; Risk Factors; Smoking
• ISSN: 0931-0509; 1460-2385
• DOI: 10.1093/ndt/16.6.1198

Background. Patients with end‐stage renal disease have an increased risk of developing coronary artery disease (CAD). The cardiovascular mortality of dialysis patients is 10–15 times higher compared with the general population. The aim of our study was to evaluate the morphological progression of coronary arteriosclerosis in this cardiovascular high‐risk group by visual assessment and quantitative coronary angiography. Methods and results. In 26 patients with chronic renal failure (age, 47±11 years; 15 male; duration of dialysis, 23±25 months) the severity of CAD and degree of coronary stenoses were assessed in two coronary angiograms after a mean follow‐up interval of 30±15 months (12–60). Baseline angiography revealed CAD in 13/22 patients (59%). The second angiography was performed as screening procedure prior to renal transplantation (n=20) and/or as follow‐up angiography after coronary angioplasty (n=10). Visual assessment showed a progression defined by the development of haemodynamically relevant stenosis of >50% luminal diameter in 13 patients. Quantitative angiographic evaluation was performed in a total of 45 segments showing >25% narrowing at the second angiogram. A progression (>15% luminal reduction) was found in 17 of 45 segments, a new lesion (initial luminal diameter