P.010 Renal Artery Stenosis and its Diagnostics in Type 2 Diabetic Patients

Abstract

Aims

The purpose of this study was to evaluate sensitivity and safety of several techniques for renal artery stenosis (RAS) detection in subjects with type 2 diabetes and coexistent hypertension.

Materials and methods

We studied 157 patients. All of patients underwent duplex sonography (DS). Patients with RAS detected by DS underwent magnetic resonance angiography (MRA) or multislice computed tomography (MSCT) of the renal arteries. We used 1.5 T MR scanner and 16 slices MSCT.

Results

We found that DS detected RAS in 58 (36.3%; 28.7% unilateral, 7.6% bilateral) type 2 diabetics (specially in smoking males) with myocardial dysfunction and rheological abnormalities. 10 patients with glomerular filtration rate (GFR) <60 ml/min but >30 ml/min underwent MRA of renal arteries and abdominal aorta with bolus injection of 20 ml gadolinium (Gd) based contrast agent. The diagnosis was confirmed in 8 cases, (6 subjects had unilateral RAS, 2 subjects had bilateral RAS) (sensitivity 80%). 28 patients with GFR >60 ml/min underwent MSCT of renal arteries and abdominal aorta with bolus injection of 50 ml “iso-osmolar” non-ionic contrast agent. The diagnosis was confirmed in 22 cases (16 subjects had unilateral RAS, 6 subjects had bilateral RAS) (sensitivity 78,6%). Serum creatinine, was recorded for three consecutive days after procedures. There was no change from the baseline in both groups.

Conclusions

DS is a valid routine method of investigation of diabetics at risk for RAS. MRA and MSCT are safe methods of RAS verification.