Hemodynamic determinants of perivascular collateral development in swine renal artery stenosis

James D. Krier, John A. Crane, Alfonso Eirin, Xiang Yang Zhu, Amir Lerman, Lilach O Lerman

Research output: Contribution to journalArticle

8 Citations (Scopus)

Abstract

Background Renal artery stenosis (RAS) resulting in reduced renal blood flow (RBF) is a common cause of secondary hypertension and deterioration of renal function, which may lead to end-stage renal disease. Recruitment and formation of periarterial collateral vessels may serve to bypass RAS and restore distal blood supply. We hypothesized that development of collaterals around RAS may preserve kidney function. Methods Collateral formation index (CI) was assessed using multidetector computed tomography as fractional vascular volume surrounding the stenosis in 31 pigs with unilateral RAS. Single kidney RBF and glomerular filtration rate (GFR) were also measured. Results Of 25 pigs that developed significant stenosis (≥65%), 8 demonstrated minor collateral development (CI < 0.3), and 17 showed major collateral development (CI ≥ 0.3). The degree of RAS was significantly higher in pigs with major collaterals compared with pigs with minor collaterals, and poststenotic kidney cortical volume, perfusion, RBF, and GFR were significantly lower. In a subset of pigs matched for the degree of RAS, RBF and GFR remained lower in pigs with major collaterals. Conclusions We conclude that collaterals develop in animals with significant RAS in proportion to its severity and might be triggered by distal injury, such as decreases in cortical volume and perfusion. However, development of collaterals was unable to confer measurable benefits for stenotic kidney function distal to severe RAS.

Original languageEnglish (US)
Pages (from-to)209-217
Number of pages9
JournalAmerican Journal of Hypertension
Volume26
Issue number2
DOIs
StatePublished - Feb 2013

Fingerprint

Renal Artery Obstruction
Swine
Hemodynamics
Renal Circulation
Glomerular Filtration Rate
Kidney
Pathologic Constriction
Perfusion
Renal Hypertension
Multidetector Computed Tomography
Chronic Kidney Failure
Blood Vessels
Wounds and Injuries

Keywords

  • blood pressure
  • collateral circulation
  • computed tomography
  • hypertension
  • renal artery stenosis
  • renal function

ASJC Scopus subject areas

  • Internal Medicine

Cite this

Hemodynamic determinants of perivascular collateral development in swine renal artery stenosis. / Krier, James D.; Crane, John A.; Eirin, Alfonso; Zhu, Xiang Yang; Lerman, Amir; Lerman, Lilach O.

In: American Journal of Hypertension, Vol. 26, No. 2, 02.2013, p. 209-217.

Research output: Contribution to journalArticle

@article{8c2d3defff8745a7aa25251e1ee77910,
title = "Hemodynamic determinants of perivascular collateral development in swine renal artery stenosis",
abstract = "Background Renal artery stenosis (RAS) resulting in reduced renal blood flow (RBF) is a common cause of secondary hypertension and deterioration of renal function, which may lead to end-stage renal disease. Recruitment and formation of periarterial collateral vessels may serve to bypass RAS and restore distal blood supply. We hypothesized that development of collaterals around RAS may preserve kidney function. Methods Collateral formation index (CI) was assessed using multidetector computed tomography as fractional vascular volume surrounding the stenosis in 31 pigs with unilateral RAS. Single kidney RBF and glomerular filtration rate (GFR) were also measured. Results Of 25 pigs that developed significant stenosis (≥65{\%}), 8 demonstrated minor collateral development (CI < 0.3), and 17 showed major collateral development (CI ≥ 0.3). The degree of RAS was significantly higher in pigs with major collaterals compared with pigs with minor collaterals, and poststenotic kidney cortical volume, perfusion, RBF, and GFR were significantly lower. In a subset of pigs matched for the degree of RAS, RBF and GFR remained lower in pigs with major collaterals. Conclusions We conclude that collaterals develop in animals with significant RAS in proportion to its severity and might be triggered by distal injury, such as decreases in cortical volume and perfusion. However, development of collaterals was unable to confer measurable benefits for stenotic kidney function distal to severe RAS.",
keywords = "blood pressure, collateral circulation, computed tomography, hypertension, renal artery stenosis, renal function",
author = "Krier, {James D.} and Crane, {John A.} and Alfonso Eirin and Zhu, {Xiang Yang} and Amir Lerman and Lerman, {Lilach O}",
year = "2013",
month = "2",
doi = "10.1093/ajh/hps010",
language = "English (US)",
volume = "26",
pages = "209--217",
journal = "American Journal of Hypertension",
issn = "0895-7061",
publisher = "Oxford University Press",
number = "2",

}

TY - JOUR

T1 - Hemodynamic determinants of perivascular collateral development in swine renal artery stenosis

AU - Krier, James D.

AU - Crane, John A.

AU - Eirin, Alfonso

AU - Zhu, Xiang Yang

AU - Lerman, Amir

AU - Lerman, Lilach O

PY - 2013/2

Y1 - 2013/2

N2 - Background Renal artery stenosis (RAS) resulting in reduced renal blood flow (RBF) is a common cause of secondary hypertension and deterioration of renal function, which may lead to end-stage renal disease. Recruitment and formation of periarterial collateral vessels may serve to bypass RAS and restore distal blood supply. We hypothesized that development of collaterals around RAS may preserve kidney function. Methods Collateral formation index (CI) was assessed using multidetector computed tomography as fractional vascular volume surrounding the stenosis in 31 pigs with unilateral RAS. Single kidney RBF and glomerular filtration rate (GFR) were also measured. Results Of 25 pigs that developed significant stenosis (≥65%), 8 demonstrated minor collateral development (CI < 0.3), and 17 showed major collateral development (CI ≥ 0.3). The degree of RAS was significantly higher in pigs with major collaterals compared with pigs with minor collaterals, and poststenotic kidney cortical volume, perfusion, RBF, and GFR were significantly lower. In a subset of pigs matched for the degree of RAS, RBF and GFR remained lower in pigs with major collaterals. Conclusions We conclude that collaterals develop in animals with significant RAS in proportion to its severity and might be triggered by distal injury, such as decreases in cortical volume and perfusion. However, development of collaterals was unable to confer measurable benefits for stenotic kidney function distal to severe RAS.

AB - Background Renal artery stenosis (RAS) resulting in reduced renal blood flow (RBF) is a common cause of secondary hypertension and deterioration of renal function, which may lead to end-stage renal disease. Recruitment and formation of periarterial collateral vessels may serve to bypass RAS and restore distal blood supply. We hypothesized that development of collaterals around RAS may preserve kidney function. Methods Collateral formation index (CI) was assessed using multidetector computed tomography as fractional vascular volume surrounding the stenosis in 31 pigs with unilateral RAS. Single kidney RBF and glomerular filtration rate (GFR) were also measured. Results Of 25 pigs that developed significant stenosis (≥65%), 8 demonstrated minor collateral development (CI < 0.3), and 17 showed major collateral development (CI ≥ 0.3). The degree of RAS was significantly higher in pigs with major collaterals compared with pigs with minor collaterals, and poststenotic kidney cortical volume, perfusion, RBF, and GFR were significantly lower. In a subset of pigs matched for the degree of RAS, RBF and GFR remained lower in pigs with major collaterals. Conclusions We conclude that collaterals develop in animals with significant RAS in proportion to its severity and might be triggered by distal injury, such as decreases in cortical volume and perfusion. However, development of collaterals was unable to confer measurable benefits for stenotic kidney function distal to severe RAS.

KW - blood pressure

KW - collateral circulation

KW - computed tomography

KW - hypertension

KW - renal artery stenosis

KW - renal function

UR - http://www.scopus.com/inward/record.url?scp=84876517406&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84876517406&partnerID=8YFLogxK

U2 - 10.1093/ajh/hps010

DO - 10.1093/ajh/hps010

M3 - Article

VL - 26

SP - 209

EP - 217

JO - American Journal of Hypertension

JF - American Journal of Hypertension

SN - 0895-7061

IS - 2

ER -