Atherosclerotic renovascular disease in older dialysis patients

We hypothesized that atherosclerotic renovascular disease (ARVD) might account for a growing proportion of end-stage renal disease in the United States because of shared risk factors and the aging of the population. We tested this hypothesis through an evaluation of 146 973 older patients starting dialysis therapy in the United States between 1996 and 2001. The proportion with ARVD prior to dialysis therapy rose from 7.1% in 1996 to 11.2% in 2001. Geographic variations in diagnosis and therapeutic management of ARVD were noted. These results show that ARVD is rapidly emerging as a major cause of end-stage renal disease in the United States.