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  • Title: Parenchymal consequences of fibromuscular dysplasia renal artery stenosis.
    Author: Mounier-Vehier C, Lions C, Jaboureck O, Devos P, Haulon S, Wibaux M, Carré A, Beregi JP.
    Journal: Am J Kidney Dis; 2002 Dec; 40(6):1138-45. PubMed ID: 12460031.
    Abstract:
    PURPOSE: The aim of this study is to assess parenchymal consequences of fibromuscular dysplasia (FMD) renal artery stenosis (RAS) in hypertensive patients by spiral computed tomographic angiography (CTA). METHODS: Spiral CTA was performed in 20 essential hypertensive (EH) patients (40 EH kidneys and 20 hypertensive patients with unilateral FMD stenosis (20 poststenotic [S] kidneys, 20 opposite [OPP] kidneys). Renal length (RL; in millimeters), mean cortical thickness (MCT; in millimeters), cortical area (CA; in square millimeters), and medullary length (ML; in millimeters) were evaluated. RESULTS: Blood pressure, creatinine clearance, and long-standing hypertension were similar in both groups of patients. Compared with EH kidneys, S and OPP kidneys showed significant cortical thinning (MCT(EH) = 9.2 +/- 0.8 mm versus MCT(OPP) = 7.8 +/- 1.0 mm versus MCT(S) = 7.3 +/- 1.0 mm; P < 0.0001). RL and ML were reduced only in the S kidney group, with RL(EH) = 103 +/- 11 mm versus RL(OPP) = 105 +/-10 mm versus RL(S) = 96 +/- 11 mm; P = 0.05; and ML(EH) = 84 +/- 11 mm versus ML(OPP) = 89 +/- 9 mm versus ML(S) = 81 +/- 10 mm; P = 0.05, respectively. CA and MCT correlated significantly with creatinine clearance in the entire population (r = 0.43; P = 0.005; r = 0.35; P = 0.02, respectively). CONCLUSION: Unilateral RAS was associated with bilateral cortical thinning in FMD disease. Cortical atrophy appears to be an accurate marker of unilateral RAS. Its use as a potential screening method for RAS should be investigated further.
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