Etiology spectrum and clinical characteristics of renal artery stenosis in a Chinese cohort

OBJECTIVE To analyze the causes of renal artery stenosis(RAS)and compare the clinical characteristics in accordance with the primary disease among patients aged from 30 to 50.METHODS Patients were grouped by etiologies of RAS.Groups were retrospectively examined and compared regarding demographic data,clinical manifestations,laboratory findings,and imaging findings.RESULTS A total of 152 patients(74 females,78 males;mean age:40.70±6.01 years)were enrolled,including 84 patients(55.3%)with atherosclerosis(AS),46 patients(30.3%)with Takayasu arteritis(TA),18 patients(11.8%)with fibromuscular dysplasia(FMD),and four patients(2.6%)with other etiologies.Patients in AS group had greater body mass index,higher prevalence of comorbidities and higher rate of smoking and drinking history.TA patients showed more constitutional symptoms and vascular findings,and higher erythrocyte sedimentation rate.RAS in both AS group and TA group mainly located on ostia and proximal segments,but RAS in FMD group mainly involved middle to distal segment of renal artery.The AS group had significantly lesser stenosis than the other groups.Although renal function evaluated by the estimated glomerular filtration rate did not significantly differ among the groups,the incidence of kidney shrinkage was significantly higher in the TA and FMD groups(39.1%and 50%,respectively)than in the AS group(8.3%).The FMD group had milder cardiac damage than other groups.CONCLUSIONS AS was the most common cause of RAS in patients aged from 30 to 50,followed by TA and FMD.The etiology of RAS should be carefully distinguished based on clinical manifestations,laboratory findings,and imaging to ensure that proper treatment is provided.

Single Nucleotide Polymorphism rs10919543 in FCGR2A/ FCGR3A Region Confers Susceptibility to Takayasu Arteritis in Chinese Population

Background： Takayasu arteritis （TA） is a rare inflammatory arteriopathy of unknown etiology. The aim of this study was to investigate the genetic susceptibility to TA in a Chinese population. Methods： Four single nucleotide polymorphisms （SNPs） those locate in the IL12B region （rs56167332）, the MLX region （rs665268）, the FCGR2A/FCGR3A locus （rsi0919543）, and the HLA-B/M1CA locus （rs12524487）, associated with TA in different population, were genotyped in 123 Chinese TA patients and 147 healthy controls from January 2013 to August 2014. A Chi-square test was used to test for genotype/allele frequencies variants. Results： Among the four SNPs, rs 10919543 was found to be significantly associated with TA in the studied population. The GG genotype of rs 10919543 at the FCGR2A/FCGR3A locus is a high risk factor （odds ratio [OR] = 6.532, 95% confidence interval [C1] = 2.402 - 17.763, P 〈 0.001 ） for TA. Among TA patients, the level of eosinophil granulocytes （Eos） in the peripheral blood was observed to be higher in the GG group of rs 10919543 （n = 23, Eos = 0. I 1 [0.08, 0.17] x 109/L） than the GA ＋ AA group （n = 100, Eos = 0.08 [0.05, 0.13] 10/L, P = 0.028）. No correlation between the genotypes of the other three SNPs and TA patients was observed. Conclusions： Our findings revealed unique genetic pattern in Chinese TA patients that may be partly responsible for the higher risk of TA in this population. FCGR2A/FCGR3A-related immune disorder might contribute to the etiology of TA.

Consensus of Chinese Specialists on Diagnosis and Treatment of Resistant Hypertension

INTRODUCTION Resistant hypertension has become a challenge in the treatment of hypertension.As the population continues to age and obesity,sleep apnea hypopnea syndrome,and chronic kidney disease increase in incidence,resistant hypertension has become an increasingly common issue in clinical practice.Failure to control blood pressure can impair target organs such as the heart,brain,and kidney,facilitating the occurrence of clinical cardiovascular events.