The Challenge of Diagnosing Atheroembolic Renal Disease

• DOI: 10.1161/circulationaha.106.680991
• Publication Date: 2007-07-03T00:50:04Z
• Authors: Francesco Scolari; Pietro Ravani; Rossella Gaggi; Marisa Santostefano; Cristiana Rollino; Nevio Stabellini; Loredana Colla; Battista Fabio Viola; Paolo Maiorca; Chiara Venturelli; Stefano Bonardelli; Pompilio Faggiano; Brendan J. Barrett
• Keywords: Aged, 80 and over; Male; Middle Aged; Prognosis; 3. Good health; Cohort Studies; 03 medical and health sciences; 0302 clinical medicine; Humans; Female; Kidney Diseases; Prospective Studies; Aged; Embolism, Cholesterol; Follow-Up Studies; Retrospective Studies

Background— Atheroembolic renal disease (AERD) is caused by showers of cholesterol crystals released eroded atherosclerotic plaques. Embolization may occur spontaneously or after angiographic/surgical procedures. We sought to determine clinical features and prognostic factors AERD. Methods Results— Incident cases AERD were enrolled at multiple sites followed up from diagnosis until dialysis death. Diagnosis was based on suspicion, confirmed histology ophthalmoscopy for all spontaneous forms most iatrogenic cases. Cox regression used model time death as a function baseline characteristics, presentation (acute/subacute versus chronic decline), extrarenal manifestations. Three hundred fifty-four subjects an average 2 years. They tended be male (83%) elderly (60% >70 years) have cardiovascular diseases (90%) abnormal (83%). occurred in 23.5% the During study, 116 patients required dialysis, 102 died. Baseline comorbidities, ie, reduced function, presence diabetes, history heart failure, acute/subacute presentation, gastrointestinal tract involvement, significant predictors event occurrence. The risk 50% lower among those receiving statins. Conclusions— Clinical are identifiable. These make possible Prognosis influenced type severity.