Clinical characteristics of ischaemic renal disease.
BACKGROUND: Longer life expectancy has favoured the ever more frequent development of ischaemic nephropathy characterized by the presence of atherosclerotic stenosis in both renal arteries. METHODS: This is an observational and multicentre study carried out during a 14-month follow-up period in 20 hospitals in SPAIN: Inclusion criteria were the presence of bilateral renal artery stenosis > 50% and a creatinine level of > or = 1.5 mg/dl. The diagnosis should be made by arterial digital angiography in every case. RESULTS: A total of 156 patients were included. Their mean age was 68.7+/-9 years, and 78.5% were male. The mean creatinine value of the group was 2.9+/-1.7 mg/dl. Arterial hypertension (BP) with a duration of 12+/-9 years was present in 97.4% of the cases, smoking habits in 69.8%, hypercholesterolaemia (> or = 240 mg/dl) in 62.9% and diabetes in 32.1%. Only 8% of the patients had a body mass index > or = 30 kg/m(2). Associated cardiovascular disease was very frequent: peripheral arteriopathy in 67.5% of the cases, ischaemic cardiopathy in 44.8%, cardiac insufficiency in 32.6% and stroke in 27.3%. In 94.4% of the patients, the lesion affected both renal arteries, with complete obstruction in 23% of the cases. CONCLUSIONS: Diagnostic suspicion of ischaemic nephropathy can be established in non-obese elderly males with chronic renal insufficiency, long-term BP evolution and cardiovascular disease at other levels, above all, peripheral arteriopathy.