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PLoS One 2021 13;16(5):e0251066. Epub 2021 May 13.

Department of Cardiology, Heart Institute (InCor), Clinical Hospital, Faculty of Medicine, University of Sao Paulo, Sao Paulo, Brazil.

Background: Chronic kidney disease is commonly found in patients with aortic stenosis (AS) undergoing transcatheter aortic valve replacement (TAVR) and has marked impact in their prognosis. It has been shown however that TAVR may improve renal function by alleviating the hemodynamic barrier imposed by AS. Nevertheless, the predictors of and clinical consequences of renal function improvement are not well established. Read More

J Endovasc Ther 2021 May 11:15266028211012403. Epub 2021 May 11.

Vascular and Endovascular Surgery, Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padua, Padua, Italy.

Purpose: To report preliminary outcomes of Viabahn Balloon-Expandable Endoprosthesis (VBX) stent-graft as bridging stent for renal arteries in fenestrated endovascular aneurysm repair (FEVAR).

Materials And Methods: Between 2018 and 2019, patients undergoing FEVAR at 3 referral Italian university hospitals were prospectively collected. During the study period, VBX was the first-line choice as bridging stent for renal arteries. Read More

Front Cardiovasc Med 2021 23;8:658952. Epub 2021 Apr 23.

Department of Cardiac Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing, China.

To determine the effect of renal artery stenosis (RAS) resulting from acute type B aortic dissection (ATBAD) with thoracic endovascular aortic repair (TEVAR) on early prognosis in patients with ATBAD. A total of 129 ATBAD patients in the National Acute Aortic Syndrome Database (AASCN) who underwent TEVAR between 2019 and 2020 were enrolled in our study. Patients were divided into two groups: the RAS group and the non-RAS group. Read More

Hypertension 2021 May 10:HYPERTENSIONAHA12016540. Epub 2021 May 10.

Hypertension Unit, AP-HP, Hôpital Européen Georges Pompidou, Paris, France. (A.-L.F., G.B., A.L., M.A., L.A.).

We aimed to compare the characteristics of the patients with renal infarction related to nontrauma renal artery dissection (RAD) with versus without an underlying vascular disease and report long-term renal and vascular outcomes, as well as new-onset renal and extra-RADs. Data from 72 consecutive patients with RAD referred to our Hypertension Unit between 2000 and 2015 were analyzed. Radiological data, including a systematic brain-to-pelvis computed tomography angiography, were independently reviewed. Read More

BMJ Case Rep 2021 May 7;14(5). Epub 2021 May 7.

Cardiology, Kitaharima Medical Center, Ono, Japan

A 79-year-old man developed bilateral intermittent claudication. Peritoneal dialysis had been initiated at 55 years of age to manage chronic renal failure. In addition, he underwent kidney transplantation at 61 years of age. Read More

Kidney Int 2021 May 5. Epub 2021 May 5.

Department of Cardiology I: Coronary and Peripheral Vascular Disease, Heart Failure, Münster University Hospital, Münster, Germany. Electronic address:

Chronic kidney disease (CKD) affects about 10% of all populations worldwide, with about 2 million people requiring dialysis. Although patients with CKD are at high risk of cardiovascular disease and events, they are often underrepresented or excluded in clinical trials, leading to important knowledge gaps about how to treat these patients. KDIGO (Kidney Disease: Improving Global Outcomes) convened the fourth clinical controversies conference on the heart, kidney and vasculature in Dublin, Ireland, in February 2020, entitled Central and Peripheral Arterial Diseases in Chronic Kidney Disease. Read More

J Am Coll Radiol 2021 May;18(5S):S174-S188

Specialty Chair, University of Alabama at Birmingham, Birmingham, Alabama, Chair, ACR Appropriateness Committee.

Renal failure can be divided into acute kidney injury and chronic kidney disease. Both are common and result in increased patient morbidity and mortality. The etiology is multifactorial and differentiation of acute kidney injury from chronic kidney disease includes clinical evaluation, laboratory tests, and imaging. Read More

Rheumatology (Oxford) 2021 May 6. Epub 2021 May 6.

Louise Coote Lupus Unit, 1st Floor, Counting House, Guy's Hospital, London, . SE1 9RT, UK.

Introduction: Case reports and small case series suggest that stenotic lesions of the renal, coeliac and mesenteric arteries may occur in the antiphospholipid syndrome (APS) resulting in clinical consequences such as hypertension and abdominal angina.

Objective: To determine the prevalence of stenotic lesions in arteries arising from the middle aorta in patients with antiphospholipid antibodies (aPL) compared with healthy, hypertensive and atherosclerotic controls.

Patients And Methods: In a cross-sectional comparative radiological study using magnetic resonance angiography (MRA) we assessed 5 groups of subjects for the prevalence of stenotic lesions in arteries arising from the middle aorta: APS/aPL positive, healthy renal donors, patients with hypertension, patients with atherosclerosis defined radiologically and patients with systemic lupus erythematosus and vasculitis who were negative for aPL. Read More

J Invasive Cardiol 2021 May 6. Epub 2021 May 6.

Division of Interventional Cardiology of MedStar, Cardiovascular Research Network at MedStar Washington Hospital Center, 110 Irving Street, Suite 4B-1, Washington, D.C., 20010.

Aim: To evaluate gender differences and mortality trends in a population undergoing transcatheter aortic valve implantation (TAVI) and to analyze the correlates to all-cause mortality at follow-up.

Methods: The study comprises a prospective cohort of 592 TAVI patients (53.4% female) treated between 2008 and 2018. Read More

Acta Biomed 2021 Apr 30;92(S1):e2021162. Epub 2021 Apr 30.

University of Parma.

Background Fibromuscolar dysplasia (FMD) is an idiopathic, non-atherosclerotic and non-inflammatory stenotic lesion of renal arteries causing renovascular hypertension up-regulating renin-angiotensin-aldosterone system. Case report: A 18-year-old man was referred to our Hypertension Center (Clinica e Terapia Medica) for the recent onset of hypertension, poorly controlled on calcium channel blockers, already associated to electrocardiographic and echocardiography signs of left ventricular hypertrophy and significant albuminuria (728 mg/24 h). An increased plasma renin activity (PRA), aldosterone level and a mild hypokalemia raised the suspicion of renovascular hypertension. Read More

Curr Opin Cardiol 2021 Apr 28. Epub 2021 Apr 28.

John Ochsner Heart and Vascular Institute, Ochsner Medical Center, New Orleans, Louisiana Pennsylvania Hospital of the University of Pennsylvania Health System, Philadelphia, Pennsylvania Ochsner Medical Center, New Orleans, Louisiana, USA.

Purpose Of Review: In the present comprehensive review, we describe the pathophysiology, indications, and evidence for both renal artery stenting and renal artery denervation. We also discuss the procedural techniques, risks, benefits, and future directions of renal intervention in the management of hypertension (HTN).

Recent Findings: Hemodynamic confirmation of lesion severity in severe renal artery stenosis is a resting or hyperemic translesional systolic gradient >20, resting or hyperemic mean translesional gradient >10 and/or renal fractional flow reserve <0. Read More

Cureus 2021 Apr 24;13(4):e14658. Epub 2021 Apr 24.

Dermatology, Brigham and Women's Hospital, Harvard Medical School, Boston, USA.

Neurofibromatosis type 1 (NF-1), also known as von Recklinghausen's disease, is an autosomal dominant multisystem genetic disorder affecting one in 2,600 individuals. It is caused by a mutation of the NF-1 gene located on chromosome 17q11.2. Read More

BMC Cardiovasc Disord 2021 Apr 26;21(1):212. Epub 2021 Apr 26.

Her Majesty's Cardiac Center, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.

Background: Endovascular treatment is standard of care for transplant renal artery stenosis (TRAS). No study has evaluated long-term outcomes compared between percutaneous transluminal renal angioplasty (PTRA) and PTRA with stenting (PTRAS). Accordingly, this study aimed to investigate the 1-year clinical success, and short- and long-term event-free survival between PTRA and PTRAS in patients diagnosed with TRAS at Thailand's largest national tertiary referral center. Read More

Harefuah 2021 Apr;160(4):210-214

Institute of Nephrology and Hypertension, Sheba Medical Center, Israel.

Introduction: Treatment of atherosclerotic renal artery stenosis (RAS) is still controversial. Several randomized controlled trials have shown that percutaneous transluminal renal angioplasty with stenting (PTRAS) is not superior to medical treatment, and the procedure is commonly reserved for malignant hypertension, flash pulmonary edema or deterioration of kidney function. The most challenging symptomatic RAS cases are patients with severe stenosis resulting in acute kidney injury (AKI) requiring acute hemodialysis. Read More

Transplant Proc 2021 Apr 21. Epub 2021 Apr 21.

General and Transplant Surgery Department, University of L'Aquila, L'Aquila, Italy; General and Transplant Surgery Department, San Salvatore Hospital, L'Aquila, Italy.

Transplant renal artery stenosis (TRAS) is a common vascular complication after kidney transplantation, leading to worsening or refractory hypertension, deterioration in renal function, and possible cause of graft loss. Early diagnosis and an appropriate treatment are crucial for organ preservation. Endovascular treatment, including percutaneous transluminal angioplasty and stent implantation, is considered the first-line therapy for TRAS. Read More

Can J Cardiol 2021 Apr 20. Epub 2021 Apr 20.

Division of Nephrology, Department of Medicine, The Ottawa Hospital, University of Ottawa. Electronic address:

We present a case of severe renal artery stenosis that mimicked a rapidly progressive glomerulonephritis with acute kidney injury, active urine sediments and severe hypertension. Simultaneous presence of secondary hyperaldosteronism and hypokalemia prompted renal angiogram and subsequent renal artery angioplasty and stenting, thus leading to rapid resolution of acute kidney injury, proteinuria, and hypertension. Our case emphasizes the importance and benefits of prompt diagnosis and revascularization of acute severe renal artery stenosis in a patient with history of atherosclerotic renovascular disease presenting with sudden onset of severe hypertension and acute kidney injury with active urine sediment mimicking rapidly progressive glomerulonephritis. Read More

Shock 2021 Apr 20. Epub 2021 Apr 20.

Universidad de Buenos Aires, Consejo Nacional de lnvestigaciones Científicas y Técnicas. Centro de Estudios Farmacológicos y Botánicos (CEFYBO). Facultad de Medicina. Buenos Aires, Argentina Facultad de Ingeniería y Ciencias Agrarias, BIOMED UCA-CONICET, Argentina Instituto de Trasplante y Alta Complejidad (ITAC), Nefrología de Buenos Aires, Buenos Aires, Argentina Fundación GADOR, Argentina Universidad de Buenos Aires, Facultad de Medicina, Departamento de Microbiología, Parasitología e Inmunología, Buenos Aires, Argentina.

Abstract: Acute kidney injury (AKI) is characterized by rapid loss of excretory function and is the clinical manifestation of several disorders affecting the kidney. The aim of the present study was to investigate the mechanism of action of Secretory Leukocyte Proteinase Inhibitor (SLPI) that protects the kidneys form AKI. In vivo and in vitro experiments were performed to assess the effect of SLPI on kidney injury. Read More

Radiol Case Rep 2021 Jun 28;16(6):1264-1270. Epub 2021 Mar 28.

Department of Medical and Surgical Sciences and Advanced Technologies "GF Ingrassia", Radiodiagnostic and Radiotherapy Unit, Catania, Italy.

Median arcuate ligament syndrome and superior mesenteric artery syndrome are well-known abdominal compression syndromes, the coexistence of which is rarely described in literature. In addition, due to the common pathogenesis, anterior nutcracker syndrome may occur simultaneously to superior mesenteric artery syndrome. To our knowledge, this is the first case reporting combination of these 3 syndromes detected with ultrasound, Computed Tomography and upper gastrointestinal fluoroscopic exam. Read More

Stem Cell Res Ther 2021 Apr 14;12(1):240. Epub 2021 Apr 14.

Division of Nephrology and Hypertension, Mayo Clinic, 200, First Street SW, Rochester, MN, 55902, USA.

Background: Atherosclerotic renal artery stenosis (ARAS) is a risk factor for ischemic and hypertensive kidney disease (HKD) for which autologous mesenchymal stem cell (MSC) appears to be a promising therapy. However, MSCs from ARAS patients exhibit impaired function, senescence, and DNA damage, possibly due to epigenetic mechanisms. Hypoxia preconditioning (HPC) exerts beneficial effects on cellular proliferation, differentiation, and gene and protein expression. Read More

Semin Cardiothorac Vasc Anesth 2021 Apr 14:10892532211008742. Epub 2021 Apr 14.

The Ohio State University Wexner Medical Center, Columbus, OH, USA.

In this article, we describe a case of a 33-year-old female with Alagille syndrome complicated by bilateral branch pulmonary artery stenosis resulting in moderate pulmonary hypertension, end-stage liver disease complicated by portal hypertension, and chronic renal disease who presented for combined liver-kidney transplant. Alagille syndrome is an autosomal dominant disease affecting the liver, heart, and kidneys. Multidisciplinary preoperative evaluation was performed with a team consisting of a congenital heart disease cardiologist, a cardiac anesthesiologist, a nephrologist, and a transplant surgeon. Read More

Pediatr Nephrol 2021 Apr 13. Epub 2021 Apr 13.

Interdisciplinary Laboratory of Medical Investigation, Faculty of Medicine, Federal University of Minas Gerais (UFMG), Belo Horizonte, MG, Brazil.

Renovascular hypertension (RVH) is defined as an elevated blood pressure caused by kidney hypoperfusion, generally as a result of anatomic stenosis of the renal artery with consequent activation of the Renin Angiotensin-Aldosterone System. The main causes include genetic and inflammatory disorders, extrinsic compression, and idiopathic alterations. RVH is often asymptomatic and should be suspected in any child with refractory hypertension, especially if other suggestive findings are present, including those with severe hypertension, abdominal bruit, and abrupt fall of glomerular filtration rate after administration of angiotensin-converting enzyme inhibitors or angiotensin-receptor blockers. Read More

Cureus 2021 Mar 10;13(3):e13799. Epub 2021 Mar 10.

Internal Medicine, Grand Strand Medical Center, Myrtle Beach, USA.

In this report, we present a case of a 55-year-old female with a past medical history of abdominal aortic aneurysm (AAA) graft, femoral-femoral bypass graft, questionable history of chronic kidney disease (CKD), abdominal hernia repair, alcoholic pancreatitis, chronic abdominal pain on opioids, and tobacco abuse who presented with acute on chronic abdominal pain with an unexplained rise of creatinine and anuria. The patient was found to have complete occlusion of AAA graft and was determined to have ischemic nephropathy (IN). Read More

Pediatr Nephrol 2021 Apr 10. Epub 2021 Apr 10.

Department of Vascular and Endovascular Surgery, Henan Provincial People's Hospital, Zhengzhou University People's Hospital, Henan University People's Hospital, 7#Weiwu Road, Zhengzhou, Henan, 450003, China.

Background: Renal artery fibromuscular dysplasia (FMD) can cause arterial stenosis, dissection, and aneurysm of renal arteries. This study aimed to analyze the clinical characteristics and evaluate the long-term outcomes of renal branch artery FMD in children and adults.

Methods: Sixty-one patients with renal artery FMD underwent endovascular treatment, including 23 children and 38 adults. Read More

Int Angiol 2021 Apr 9. Epub 2021 Apr 9.

Vascular Surgery Department, Policlinico Umberto I, Sapienza University of Rome, Rome, Italy.

Background: The aim of this work is to compare the diagnostic accuracy of Duplex ultrasound (DUS) and CT angiography (CTA) in the study of arterial vessels, in patients with chronic peripheral arterial disease (PAD) of the lower limbs to undergo endovascular revascularization with the use of intraprocedural digital angiography (DSA).

Methods: 94 patients with obstructive pathology of the arterial axes of the lower limbs were enrolled in the study. In all patients, endovascular revascularization treatment was considered the most suitable therapeutic choice. Read More

CEN Case Rep 2021 Apr 7. Epub 2021 Apr 7.

Department of Nephrology, Hyogo Prefectural Kobe Children's Hospital, 1-6-7 Minatojima-minamimachi, Chuo-ku, Kobe, Hyogo, 650-0047, Japan.

Moyamoya disease (MMD) has long been known to be associated with hypertension. While renal artery stenosis (RAS) is considered one of the causes of hypertension with MMD, most hypertension causes remain unexplained. A boy with MMD was diagnosed with renovascular hypertension (RVH) due to left-sided RAS by angiography. Read More

Cells 2021 Mar 31;10(4). Epub 2021 Mar 31.

Mayo Clinic, Human Cell Therapy Laboratory, Rochester, MN 55905, USA.

Ischemic nephropathy reflects progressive loss of kidney function due to large vessel atherosclerotic occlusive disease. Recent studies indicate that this process is characterized by microvascular rarefaction, increased tissue hypoxia and activation of inflammatory processes of tissue injury. This review summarizes the rationale and application of functional MR imaging to evaluate tissue oxygenation in human subjects that defines the limits of renal adaptation to reduction in blood flow, development of increasingly severe tissue hypoxia and recruitment of inflammatory injury pathways in ischemic nephropathy. Read More

Children (Basel) 2021 Mar 25;8(4). Epub 2021 Mar 25.

Pediatric Otolaryngology Head Neck Surgery, Children Hospital "ASST Spedali Civili", 25123 Brescia, Italy.

We discuss two cases of congenital airway malformations seen in our neonatal intensive care unit (NICU). The aim is to report extremely rare events characterized by immediate respiratory distress after delivery and the impossibility to ventilate and intubate the airway. The first case is a male twin born at 34 weeks by emergency caesarean section. Read More

Life (Basel) 2021 Mar 7;11(3). Epub 2021 Mar 7.

Department of Clinical Pharmacology, Wroclaw Medical University, Wroclaw, Poland.

Renal artery stenosis (RAS) is conditioned mainly by two disturbances: fibromuscular dysplasia or atherosclerosis of the renal artery. RAS is an example of renovascular disease, with complex pathophysiology and consequences. There are multiple pathophysiological mechanisms triggered in response to significant renal artery stenosis, including disturbances within endothelin, kinin-kallikrein and sympathetic nervous systems, with angiotensin II and the renin-angiotensin-aldosterone system (RAAS) playing a central and key role in the pathogenesis of RAS. Read More

J Hum Hypertens 2021 Mar 30. Epub 2021 Mar 30.

Endocrine Hypertension Research Centre, University of Queensland Diamantina Institute, Princess Alexandra Hospital, Woolloongabba, QLD, Australia.

Although the aldosterone/renin ratio (ARR) is the preferred screening test for primary aldosteronism (PA), patients with non-suppressed renin and a falsely negative ARR on non-interfering medications have occasionally been reported. This report describes the clinical characteristics and outcomes of seven patients with proven aldosterone-producing adenoma (APA) and non-suppressed renin.Chart review of seven PA patients with an APA and a non-suppressed plasma renin concentration (PRC > 8. Read More

Clin Nephrol 2021 Mar 26. Epub 2021 Mar 26.

Moyamoya disease (MMD) is the most common underlying disease in Korean pediatric renovascular hypertension (RVH). The () p.R4810K variant is reported to be a pathologic variant in East Asian MMD. Read More