Effect of Renal-Artery Stenting on Progression of Renovascular Renal Failure

Harden, P. N.; MacLeod, Mary Joan; Rodger, R. S. C.; Baxter, Grant M.; Connell, John; Dominiczak, A. F.; Junor, B. J. R.; Brigs, J.D.; Moss, Jonathan

doi:10.1016/s0022-5347(01)61848-2

Cited by 21 publications

(35 citation statements)

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“…Improvement or stabilisation of renal function has been variable, with different groups reporting response values of 50–70% 121-124. A prospective study of PTRA plus stenting, although demonstrating improvement or stabilisation of renal function in 69% of patients, also reported a one-year mortality rate of 40% 125. Observations such as this reinforce the need for careful patient selection.…”

Section: Treatmentmentioning

confidence: 85%

Atherosclerotic renal artery stenosis: from diagnosis to treatment

Carmichael

1999

Postgraduate Medical Journal

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Section: Treatmentmentioning

confidence: 85%

Atherosclerotic renal artery stenosis: from diagnosis to treatment

Carmichael

1999

Postgraduate Medical Journal

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“…It was also shown here that both the systolic and diastolic BPs were significantly reduced after PTRAS. Similarly, stenting in ARAS has been significantly associated with decreased BP in other studies [15,[17][18][19]24,29].…”

Section: Discussionmentioning

confidence: 71%

“…PTRAS is not only a less invasive procedure but is also associated with fewer complications and lower procedure-related mortality rates [16,17]. However, the effects of renal stenting on blood pressure (BP) control and the improvement or even maintenance of renal function are still a subject of debate [18,19]. Factors predicting a beneficial outcome also remain controversial.…”

Section: Introductionmentioning

confidence: 99%

Effect of baseline glomerular filtration rate on renal function following stenting for atherosclerotic renal artery stenosis

Chang

Kim

et al. 2010

Scandinavian Journal of Urology and Nephrology

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“…Several weaknesses have been identified with these trials including the small number of patients, cross over, selection bias, and potential of under powering of the trials [8, 12, 13]. Observational studies and results of registries suggest that technically successful revascularization confers a substantial survival benefit to some "high risk" patient subsets [5, 6, 14–20]. Because this population often includes older subjects with the presence of extensive comorbid cardiovascular disease, identifying predictors for all-cause mortality and/or progression to renal replacement therapy (RRT with hemodialysis, peritoneal dialysis, or kidney transplantation) is an important goal in planning therapy.…”

Section: Introductionmentioning

confidence: 99%

Mortality and Renal Replacement Therapy after Renal Artery Stent Placement for Atherosclerotic Renovascular Disease

Misra

Khosla

Allred

et al. 2016

Journal of Vascular and Interventional Radiology

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Purpose To identify the risk factors for progression to renal replacement therapy (RRT) and all-cause mortality in patients who underwent renal artery (RA) stent placement for atherosclerotic renal artery stenosis (RAS). Materials and Methods A retrospective study was performed from June 1996 to June 2009 that identified 1052 patients that underwent RA stent placement. The glomerular filtration rate at the time of RA stent placement was estimated from the serum creatinine level and divided into renal disease stages 1–5. Univariate and multivariable Cox proportional hazards models were used to determine which factors were associated with each endpoint. Results The times to progression to all-cause mortality and RRT were similar for chronic kidney (CKD) stages 1/2/3A and served as the reference group. In multivariable analysis, high-grade proteinuria (P<.001), higher CKD stage [stage 5 vs. 1-3A, (P<.001)], stage 4 vs. 1-3A, (P<.001), stage 3B vs. 1-3A, (P=.02)] remained independently associated with increased risk of progression to RRT. Angiotensin-converting enzyme inhibitor/angiotensin receptor blocker (ACEi/ARB) use was associated with decreased risk of progression to RRT (P=0.03). Higher CKD stage [stage 5 vs. 1-3A, (P<.001), stage 4 vs. 1-3A (P=.004), carotid artery disease (P<.001), diabetes mellitus (P=.002), and high-grade proteinuria (P<.001) remained independently associated with all-cause mortality. Statin use was associated with decreased risk of all-cause mortality (P< 0.001). Conclusion Based on this analysis, patients with atherosclerotic RAS who undergo RA stenting who have high-grade proteinuria and CKD stage 3B, 4 or 5 have an increased risk of progression to RRT. Patients with high-grade proteinuria, CKD stage 3B, 4 or 5, carotid disease or diabetes have an increased risk for all-cause mortality after renal artery stenting. ACEi/ARB use in this patient population has a decreased risk of progression to RRT and patients on statins have a decreased risk of all-cause mortality.

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Effect of Renal-Artery Stenting on Progression of Renovascular Renal Failure

Cited by 21 publications

References 0 publications

Atherosclerotic renal artery stenosis: from diagnosis to treatment

Atherosclerotic renal artery stenosis: from diagnosis to treatment

Effect of baseline glomerular filtration rate on renal function following stenting for atherosclerotic renal artery stenosis

Mortality and Renal Replacement Therapy after Renal Artery Stent Placement for Atherosclerotic Renovascular Disease

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