Long-Term Outcomes of Renal Artery Involvement in Takayasu Arteritis

Seokchan Hong¹, Oh Chan Kwon², Byeongzu Ghang³, Yong-Gil Kim¹, Chang-Keun Lee¹ and Bin Yoo¹, ¹Division of Rheumatology, Department of Internal Medicine, University of Ulsan College of Medicine, Asan Medical Center, Seoul, South Korea, ²Division of Rheumatology, Department of Internal Medicine, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea, The Republic of, ³Division of Rheumatology, Department of Internal Medicine, Univerisy of Ulsan College of Medicine, Asan Medical Center, Seoul, South Korea

Meeting: 2016 ACR/ARHP Annual Meeting

Date of first publication: September 28, 2016

Keywords: hypertension, takayasu arteritis and vasculitis

Session Information

Date: Sunday, November 13, 2016

Title: Vasculitis - Poster I: Large Vessel Vasculitis and Polymyalgia Rheumatica

Session Type: ACR Poster Session A

Session Time: 9:00AM-11:00AM

Long-term Outcomes of Renal Artery Involvement in Takayasu Arteritis

Background/Purpose: Takayasu arteritis (TA) involving the renal artery can result in hypertension, renal dysfunction, and premature death. Some patients with renal artery stenosis underwent revascularization procedures including stent insertion. The aim of this study was to investigate the long-term outcomes and factors that predict outcomes in TA patients with renal artery stenosis.

Methods: The medical records of patients diagnosed with TA between January 1997 and December 2014 were reviewed retrospectively. Renal artery involvement was based on CT and/or angiography findings. Poor outcome was defined as uncontrolled hypertension, chronic renal insufficiency, or death.

Results: Of the 62 TA patients with renal artery involvement, 11 (17.7%) underwent renal artery revascularization. Younger age, male gender, and more severe (>70%) stenosis were associated with vascular intervention. After a median follow-up of 90.6 months, 11 (17.7%) of the 62 patients had uncontrolled hypertension and six (9.7%) had chronic renal insufficiency, but these outcomes were not significantly associated with vascular intervention. Renal insufficiency (5/15 [33.3%] vs 3/47 [6.4%], p=0.016) and bilateral involvement (12/15 [80.0%] vs 23/47 [48.9%], p = 0.041) were significantly more frequent in patients with poor than good outcomes. Multivariate Cox analysis revealed that renal insufficiency at presentation (hazard ratio [HR]=13.778, 95% confidence interval [CI]=3.530–53.786; p=0.000) and bilateral renal artery involvement (HR=5.053, 95% CI=1.179–21.661; p=0.029) were significant risk factors for poor outcomes at follow-up, but revascularization procedure was not (HR=0.663, 95% CI=0.176–2.498; p=0.543) (Table 1).

Conclusion: Bilateral lesions and renal functional impairment at presentation, but not implementation of revascularization procedures, were significant factors for outcomes in TA patients with renal artery involvement.

Table 1. Multivariate analysis of clinical factors predictive of poor outcome in TA patients with renal artery involvement

	HR	95% CI	P-value
Renal impairment at presentation^a	13.778	3.530–53.786	0.000
Bilateral involvement	5.053	1.179–21.661	0.029
Revascularization	0.663	0.176–2.498	0.543

^aRenal insufficiency was defined as an estimated glomerular filtration rate < 60 ml/minute. CI: confidence interval; HR: hazard ratio.

Disclosure: S. Hong, None; O. C. Kwon, None; B. Ghang, None; Y. G. Kim, None; C. K. Lee, None; B. Yoo, None.

To cite this abstract in AMA style:

Hong S, Kwon OC, Ghang B, Kim YG, Lee CK, Yoo B. Long-Term Outcomes of Renal Artery Involvement in Takayasu Arteritis [abstract]. Arthritis Rheumatol. 2016; 68 (suppl 10). https://acrabstracts.org/abstract/long-term-outcomes-of-renal-artery-involvement-in-takayasu-arteritis/. Accessed .

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