Clinical Study
Renal Artery Fibromuscular Dysplasia in 2,640 Renal Donor Subjects: A CT Angiography Analysis

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Abstract

Purpose

To present the incidence, demographics, and clinical presentation of patients diagnosed with renal fibromuscular dysplasia (FMD) who underwent computed tomography (CT) angiography for evaluation of living renal donor protocol.

Methods and Materials

A retrospective review was performed from January 1, 2000, to December 31, 2011 on patients who underwent CT angiography for evaluation of living renal donor protocol. Of 2,640 patients identified, only patients with a diagnosis of FMD by the radiology report underwent independent reader evaluation of CT angiography for the presence of FMD and associated characteristics. The demographics, medical history, and presentation were reviewed using the electronic medical chart.

Results

The independent readers who evaluated CT angiography identified a diagnosis of FMD in 68 patients (2.6%; 59 female) with an average age of 52 years ± 10. Unilateral FMD was observed in 46 patients (68%), and bilateral FMD was observed in 22 patients (32%). Three patients had aneurysms of the renal artery. Comorbidities included hypertension (n = 21, 31%), dyslipidemia, (n = 13, 19%), history of migraines (n = 3, 4%), and history of smoking (n = 14, 21%). No patients had diabetes mellitus, coronary artery disease, or family history of FMD. Of 21 patients (31%) with a history of hypertension, 13 patients (62%) were treated with antihypertensive medications.

Conclusions

The incidence of FMD in patients who underwent CT angiography for evaluation of living renal donor protocol is 2.6%.

Section snippets

Study Population

Institutional review board approval was obtained before conducting the study. From January 1, 2000, to December 31, 2011, the radiology information management system database was searched for an examination code of abdominal or pelvic CT angiography and a key phrase “potential renal donor.” Cases of FMD were also searched using key words “fibromuscular dysplasia,” “FMD,” “beaded,” “pearl,” or “string,” in any and all combinations within the interpretation of CT angiography. Patients with a

Patient Characteristics

As part of a renal donor protocol, 2,640 patients underwent CT angiography scans of the abdomen and pelvis. The CT angiography report identified a diagnosis of FMD in 68 (2.6%) patients with an average age of 52 years ± 10 ; 59 patients (87%) were women (Table 1). Cardiovascular risk factors included hypertension (n = 21, 31%), dyslipidemia (n = 13, 19%), history of smoking (n = 14, 21%), and history of migraines (n = 3, 4%). Five patients (7%) had a history of use of oral contraceptive pills

Discussion

In the present study, based on CT angiography results, a 2.6% incidence of renal artery FMD in renal donor patients was observed. As expected, most of the patients (87%) were women. The average age of patients was 52 years. Patients presented with bilateral FMD approximately one third of the time with most patients having right-sided involvement. Three patients had renal artery aneurysms. Three patients presented with extrarenal FMD involving the external iliac artery or superior mesenteric

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This work was funded by a R01HL098967 (S.M.) from the National Heart, Lung and Blood Institute.

None of the authors have identified a conflict of interest.

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