Renal artery involvement is associated with increased morbidity but not mortality in Takayasu arteritis: a matched cohort study of 215 patients
Background We analyzed differences in presentation and survival of Takayasu arteritis (TAK) with or without renal artery involvement (RAI) from a large monocentric cohort of patients with TAK. Methods Clinical and angiographic features were compared between TAK with versus without RAI, with bilateral versus unilateral RAI, and with bilateral RAI versus without RAI using multivariable-adjusted logistic regression. Inter-group differences in survival were analyzed [hazard ratios (HR) with 95% confidence intervals (95%CI)] adjusted for gender, age at disease onset, diagnostic delay, baseline disease activity, and significant clinical/angiographic inter-group differences after multivariable-adjustment/propensity score matching (PSM). Results Of 215 TAK, 117(54.42%) had RAI [66(56.41%) bilateral]. TAK with RAI or with bilateral RAI had earlier disease onset than without RAI (p < 0.001). Chronic renal failure (CRF) was exclusively seen in TAK with RAI. TAK with RAI (vs without RAI) had more frequent hypertension (p = 0.001), heart failure (p = 0.047), abdominal aorta (p = 0.001) or superior mesenteric artery involvement (p = 0.018). TAK with bilateral RAI (vs unilateral RAI) more often had hypertension (p = 0.011) and blurring of vision (p = 0.049). TAK with bilateral RAI (vs without RAI) more frequently had hypertension (p = 0.002), heart failure (p = 0.036), abdominal aorta (p < 0.001), superior mesenteric artery (p = 0.002), or left subclavian artery involvement (p = 0.041). Despite higher morbidity (hypertension, CRF), mortality risk was not increased with RAI vs without RAI (HR 2.32, 95%CI 0.61–8.78), with bilateral RAI vs unilateral RAI (HR 2.65, 95%CI 0.52–13.42) or without RAI (HR 3.16, 95%CI 0.79–12.70) even after multivariable adjustment or PSM. Conclusion RAI is associated with increased morbidity (CRF, hypertension, heart failure) but does not adversely affect survival in TAK. Key Points•Renal artery involvement in TAK is associated with chronic renal failure.•TAK with renal artery involvement more often have heart failure and hypertension.•Bilateral renal artery involvement (compared with unilateral) is more often associated with hypertension and visual symptoms.•Renal artery involvement is not associated with an increased risk of mortality in TAK..
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2023 |
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| Erschienen: |
2023 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:43 |
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| Enthalten in: |
Clinical rheumatology - 43(2023), 1 vom: 05. Dez., Seite 67-80 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Thakare, Darpan R. [VerfasserIn] |
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| Links: |
Volltext [lizenzpflichtig] |
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| Themen: |
Angiography |
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| Anmerkungen: |
© The Author(s), under exclusive licence to International League of Associations for Rheumatology (ILAR) 2023. Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law. |
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| doi: |
10.1007/s10067-023-06829-9 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| 245 | 1 | 0 | |a Renal artery involvement is associated with increased morbidity but not mortality in Takayasu arteritis: a matched cohort study of 215 patients |
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| 520 | |a Background We analyzed differences in presentation and survival of Takayasu arteritis (TAK) with or without renal artery involvement (RAI) from a large monocentric cohort of patients with TAK. Methods Clinical and angiographic features were compared between TAK with versus without RAI, with bilateral versus unilateral RAI, and with bilateral RAI versus without RAI using multivariable-adjusted logistic regression. Inter-group differences in survival were analyzed [hazard ratios (HR) with 95% confidence intervals (95%CI)] adjusted for gender, age at disease onset, diagnostic delay, baseline disease activity, and significant clinical/angiographic inter-group differences after multivariable-adjustment/propensity score matching (PSM). Results Of 215 TAK, 117(54.42%) had RAI [66(56.41%) bilateral]. TAK with RAI or with bilateral RAI had earlier disease onset than without RAI (p < 0.001). Chronic renal failure (CRF) was exclusively seen in TAK with RAI. TAK with RAI (vs without RAI) had more frequent hypertension (p = 0.001), heart failure (p = 0.047), abdominal aorta (p = 0.001) or superior mesenteric artery involvement (p = 0.018). TAK with bilateral RAI (vs unilateral RAI) more often had hypertension (p = 0.011) and blurring of vision (p = 0.049). TAK with bilateral RAI (vs without RAI) more frequently had hypertension (p = 0.002), heart failure (p = 0.036), abdominal aorta (p < 0.001), superior mesenteric artery (p = 0.002), or left subclavian artery involvement (p = 0.041). Despite higher morbidity (hypertension, CRF), mortality risk was not increased with RAI vs without RAI (HR 2.32, 95%CI 0.61–8.78), with bilateral RAI vs unilateral RAI (HR 2.65, 95%CI 0.52–13.42) or without RAI (HR 3.16, 95%CI 0.79–12.70) even after multivariable adjustment or PSM. Conclusion RAI is associated with increased morbidity (CRF, hypertension, heart failure) but does not adversely affect survival in TAK. Key Points•Renal artery involvement in TAK is associated with chronic renal failure.•TAK with renal artery involvement more often have heart failure and hypertension.•Bilateral renal artery involvement (compared with unilateral) is more often associated with hypertension and visual symptoms.•Renal artery involvement is not associated with an increased risk of mortality in TAK. | ||
| 650 | 4 | |a Aortitis syndrome |7 (dpeaa)DE-He213 | |
| 650 | 4 | |a Angiography |7 (dpeaa)DE-He213 | |
| 650 | 4 | |a Interventional radiology |7 (dpeaa)DE-He213 | |
| 650 | 4 | |a Renal artery stenosis |7 (dpeaa)DE-He213 | |
| 650 | 4 | |a Renal artery obstruction |7 (dpeaa)DE-He213 | |
| 650 | 4 | |a Takayasu arteritis |7 (dpeaa)DE-He213 | |
| 700 | 1 | |a Mishra, Prabhaker |4 aut | |
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