Clinical implications of the accessory renal artery. A systematic literature review
Abstract
Objective: To establish some of the possible surgical and clinical implications related to the presence of accessory renal arteries and their relationship with relevant health outcomes like resistant systemic hypertension and acute rejection of renal transplantation. Methods: Systematic review of the literature registered in the International prospective register of systematic reviews. Four blinded authors carried out their search from 2008 to 2018, according to the inclusion criteria, pre-established terms, and combinations, in five databases and the Zotero bibliographic reference manager, quality assessment with the Study Quality Assessment Tools, from the National Heart, Lung, and Blood Institute, and calculation of Kappa indices. Results: 32 selected studies exceeded the minimum score in the assessment of methodological quality, revealing a low risk of bias. The degree of agreement between the reviewers was 0.81-1.0, interpreted as almost perfect concordance. The characteristics of the studies, according to the year of publication, were considerable for the years 2013 and 2009. Most of the studies were carried out in the United States, followed by other countries. Based on the outcomes, the following studies were found, six for systemic arterial hypertension and 26 for kidney transplantation. Conclusions: The presence of accessory renal arteries is one of the possible causes when assessing hypertension patients with refractoriness to conventional treatment. For its part, incidence of acute rejection and post-transplantation loss of viability are near 20% in patients treated with accessory renal arteries; it is associated with urological and systemic complications.
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