THE IMPACT OF MULTIPLE RENAL ARTERIES ON HYPERTENSION AND CARDIOVASCULAR RISK: A COMPARATIVE ANALYSIS

Objective: Background:Multiple renal arteries (MRA) are a common anatomical variation, but their role in hypertension and cardiovascular (CV) risk remains unclear. This study evaluates differences in hemodynamic, metabolic, renal, and cardiac parameters in patients with and without MRA.Design and method: Methods: A total of 40 participants were divided into a control group (n=20, single renal artery) and an MRA group (n=20, multiple renal arteries). Clinical, biochemical, and cardiovascular parameters were analyzed using statistical tests and logistic regression. Results: Blood Pressure and Ambulatory Monitoring: ° The MRA group had higher systolic BP (150 vs. 137 mmHg, p=0.04) and a trend toward higher ABPM values. Renal and Cardiac Function: ° eGFR was higher in MRA (106.5 vs. 102 ml/min/1.73m2, p=0.39), within the hyperfiltration range, while lower eGFR in controls may be related to greater antihypertensive therapy use (65% vs. 45%). ° A1 albuminuria was more frequent in MRA (63% vs. 50%), whereas A2 albuminuria was more common in controls (50% vs. 32%), possibly contributing to their higher Framingham CV risk (29.5% vs. 17.0%, p=0.04). ° The MRA group showed trends toward higher HR, NT-proBNP, IVS thickness, and 24-hour Na/K ratio, though not statistically significant. Metabolic and Cardiovascular Risk Factors: ° HOMA-IR was higher in MRA (5.6 vs. 4.6, p=0.03), indicating greater insulin resistance. ° Controls were older (42.5 vs. 38.0 years, p=0.41) and had greater use of statins (20% vs. 0%), reflecting a longer history of hypertension and dyslipidemia. Conclusions: Conclusion: Multiple renal arteries were associated with higher blood pressure and insulin resistance, while their impact on overall cardiovascular risk remains unclear. The higher CV risk in the control group may be explained by older age, more frequent antihypertensive and statin therapy use, and more severe albuminuria. It is possible that MRA contributes to hemodynamic and metabolic changes, but its role in long-term CV risk requires further investigation in larger cohorts.