Correlation Study Between Accessory Renal Artery And Hypertension

Objective: To clarify the detection rate of the accessory renal artery（ARA）and the relationship with hypertension.Methods: To retrospectively analyze the clinical data of 194 patients who underwent CT angiography（CTA）or magnetic resonance angiography（MRA）of the renal artery from January 2018 to June 2021 at the First Affiliated Hospital of Dali University for various reasons.ARA was defined according to two criteria commonly used in China and abroad.ARA was defined by foreign standards as multiple arteries from the aorta or its branches to the kidney（excluding the advanced branches of the renal artery）,called multiple renal arteries,with the one had the largest diameter being called the main renal artery and the others being called ARA.The characteristics of ARA were analyzed.Hypertension was defined as office blood pressure ≥140/90 mm Hg,or 24-hour ambulatory blood pressure ≥130/80 mm Hg,or a previous diagnosis of hypertension and current antihypertensive treatment.A combination of t-tests,chi-square tests,and logistic regression was used to compare the clinical characteristics,levels of the renin-angiotensin-aldosterone system,blood pressure levels,and the relationship with hypertension in the groups with and without ARA.Results1.According to the China standard,ARA was detected in 64 of 194 patients,with a detection rate of 32.99%;according to the foreign standard,ARA was detected in 55 patients,with a detection rate of 28.35%.Regardless of the definition used,ARA originated mainly from the abdominal aorta.According to the China standard,the detection rate was higher in men than in women（P=0.022）,but the detection rate of ARA was similar in the left and right kidneys.2.The clinical characteristics,blood pressure levels,and the hormone levels of the renin-angiotensin-aldosterone system were compared between the group with and without ARA according to the China criteria.It was found that the differences in bilateral kidney size,bilateral renal artery diameter,blood urea nitrogen,blood creatinine,glomerular filtration rate,24-hour systolic blood pressure,24-hour diastolic blood pressure,plasma supine/standing renin,and aldosterone levels between the two groups were not statistically significant（P≥0.103）.3.Hypertensive patients had a higher body mass index,triglyceride levels,more males,a higher prevalence of smoking and alcohol consumption,and relatively lower blood potassium and urea levels than those with normal blood pressure（P≤0.030）.Although the detection rate of ARA was higher in hypertensive patients than in those with normal blood pressure,the differences in the number of ARA,bilateral main renal artery diameter,bilateral kidney length and width,blood creatinine,and glomerular filtration rate between the two groups were not statistically significant（P ≥0.060）.4.Binary logistic regression analysis found that body mass index was an independent determinant of hypertension,with each 1 kg/m2 increase in body mass index associated with a 21.6% increase in the risk of prevalent hypertension（OR=1.216,95% CI:1.021-1.449）.ARA was not an independent risk factor for hypertension.Conclusion: This study found that the detection rate of ARA was high regardless of the definition used.ARA was not significantly associated with renin-angiotensin-aldosterone system activity,blood pressure levels,or renal function,and was not an independent risk factor for the development of hypertension.