Predictors of clinical outcome after stent placement in atherosclerotic renal artery stenosis: a systematic review and meta-analysis of prospective studies

Abstract

The present review did not find a clinical characteristic that reliably predicts renal function outcome. High baseline pulse pressure predicted a smaller decrease in SBP after intervention and the best clinical predictor for a larger DBP reduction was a high pretreatment DBP.

Changes in Glomerular Filtration Rate After Renal Revascularization Correlate With Microvascular Hemodynamics and Inflammation in Swine Renal Artery Stenosis

“…A low 32 or rapidly-declining GFR 33 before revascularization are associated with favorable renal outcomes in RAS patients. Alas, a recent meta-regression analysis of prospective studies could not identify consistent clinical predictors of favorable renal outcome after revascularization 34 .…”

The utility of renal venous renin studies in selection of patients with renal artery stenosis for angioplasty

“…Dichotomous data were compared using Fisher's exact tests and continuous variables with Student's t-tests for normal and Mann-Whitney U tests for nonparametric distributions. Univariate logistic regression was performed with variables known or thought likely to predict favourable BP response (age, sex, resistant hypertension, fibromuscular dysplasia, bilateral RAS, stent insertion, baseline DDD, RVRR and CLSR positivity) [18,19]. Multivariate logistic regression analysis was carried out using variables significantly associated with treatment benefit on univariate analysis.…”

“…The results of these trials underscore the need to identify patients who are more likely to respond to angioplasty (with or without stent). Apart from new onset of severe hypertension, rapidly worsening renal function, recurrent flash pulmonary oedema and refractory heart failure, no clinical parameters have consistently been associated with a high likelihood of treatment benefit from revascularization [3,18,22]. The renal resistive index appeared initially to be useful, with higher values predicting poorer responses [26], but is highly operator-dependent and results have been inconsistent [27][28][29].…”

Revascularization as a treatment to improve renal function

“…54 However, a number of studies have looked at other ways of predicting response to revascularization in ARVD, either through imaging techniques or biomarker measurement.…”