Clinical StudyRenal Artery Fibromuscular Dysplasia in 2,640 Renal Donor Subjects: A CT Angiography Analysis
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
References (14)
- et al.
Fibromuscular dysplasia in living renal donors: still a challenge to computed tomographic angiography
Eur J Radiol
(2010) - et al.
Multidetector spiral CT renal angiography in the diagnosis of renal artery fibromuscular dysplasia
Eur J Radiol
(2007) - et al.
Renal artery evaluation: comparison of spiral CT angiography to intra-arterial DSA
J Vasc Interv Radiol
(1998) - et al.
Renal fibromuscular dysplasia in elderly persons
Am J Kidney Dis
(2005) - et al.
The United States Registry for Fibromuscular Dysplasia: results in the first 447 patients
Circulation
(2012) - et al.
Incidental fibromuscular dysplasia in potential renal donors: long-term clinical follow-up
Radiology
(1989) - et al.
Arteriographic detection of renovascular disease in potential renal donors: incidence and effect on donor surgery
Radiology
(2000)
Cited by (38)
Transplant Renal Artery Stenosis
2020, Kidney International ReportsCitation Excerpt :The unusual distal location and relative length of stenosis seen here raises the possibility of fibromuscular dysplasia, a nonatherosclerotic, noninflammatory disease that may have been pre-existent but not yet clinically apparent in the young female donor (Table 1). Assessment of living donors has shown that up to 2.6% had computed tomographic angiographic evidence of fibromuscular dysplasia, of whom 87% were female.5 This suggests that fibromuscular dysplasia may be a more common cause of TRAS following cadaveric transplantation than previously appreciated.
Lack of Association of Spontaneous Coronary Artery Dissection With Autoimmune Disease
2020, Journal of the American College of CardiologyNonatherosclerotic Abdominal Vasculopathies
2019, Annals of Vascular SurgeryCitation Excerpt :With our current management approach, most of our patients showed good clinical and imaging improvements which is better than what other centers had reported for diseases such as SAM. FMD has a strong female predominance with prior literature reports showing females accounting for 80–90% of patients with an average age of 52 at presentation.22–25 Based on the criteria of our study, we only included FMD patients with renal and mesenteric artery involvement and thus expect some of our results to vary from other FMD analyses.
Prevalence, Presentation, and Associated Conditions of Patients With Fibromuscular Dysplasia
2019, American Journal of CardiologyCitation Excerpt :This suggests that while FMD is postulated to be a systemic disease,16 its involvement can be heterogeneous. Previous studies have reported that the prevalence of renal FMD is 0.4%, whereas the estimated prevalence of craniocervical FMD is much lower at 0.1%.27 Stroke risk factor modification and antiplatelet agents may be useful in management of cerebral FMD and require further study.
Screening CT Angiography of the Aorta, Visceral Branch Vessels, and Pelvic Arteries in Fibromuscular Dysplasia
2017, JACC: Cardiovascular ImagingCitation Excerpt :Invasive techniques such as digital subtraction angiography (DSA) would likely improve the detection of subtle vascular abnormalities in this patient population. A review of DSA in potential renal donors demonstrated an FMD incidence of 3.8% (6) versus 2.6% with CTA (7), suggesting that DSA may be an attractive option when there is high suspicion that intervention will be required. However, the risk, time, and cost associated with this approach make it a less appealing option for the assessment of large vascular territories.
Inferior Long-Term Graft Survival of Suboptimal Kidneys After Living Donor Kidney Transplantation
2020, Transplantation Proceedings
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.