Renovascular Hypertension. Anatomic and Remal Function Changes During Drug Therapy

Dean, Richard H.; Kieffer, Robert W.; Smith, Blaine E.; Oates, John A.; Nadeau, John; Hollifield, John W.; Dupont, William D.

doi:10.1016/s0022-5347(17)54213-5

Cited by 68 publications

(84 citation statements)

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“…Similar to previous studies (Dean et al, 1981), we found insignificant changes in eGFR during the follow-up period whether or not PTRAS was performed. However, whether the patient received PTRAS or not, the CIN rate in our study was not significantly different between groups, and was comparable with the rates reported in other studies (Chábová et al, 2000;Su et al, 2013).…”

Section: Discussionsupporting

confidence: 91%

Concomitant coronary and renal revascularization improves left ventricular hypertrophy more than coronary stenting alone in patients with ischemic heart and renal disease

Dong

Huang

Luo

et al. 2016

J. Zhejiang Univ. Sci. B

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Percutaneous transluminal renal artery stenting (PTRAS) has been proved to have no more benefit than medication alone in treating atherosclerotic renal artery stenosis (ARAS). Whether PTRAS could improve left ventricular hypertrophy (LVH) and reduce adverse events when based on percutaneous coronary intervention (PCI) for patients with coronary artery disease (CAD) and ARAS is still unclear. A retrospective study was conducted, which explored the effect of concomitant PCI and PTRAS versus PCI alone for patients with CAD and ARAS complicated by heart failure with preserved ejection fraction (HFpEF). A total of 228 patients meeting inclusion criteria were divided into two groups: (1) the HFpEF-I group, with PCI and PTRAS; (2) the HFpEF-II group, with PCI alone. Both groups had a two-year follow-up. The left ventricular mass index (LVMI) and other clinical characteristics were compared between groups. During the follow-up period, a substantial decrease in systolic blood pressure (SBP) was observed in the HFpEF-I group, but not in the HFpEF-II group. There was marked decrease in LVMI in both groups, but the HFpEF-I group showed a greater decrease than the HFpEF-II group. Regression analysis demonstrated that PTRAS was significantly associated with LVMI reduction and fewer adverse events after adjusting for other factors. In HFpEF patients with both CAD and ARAS, concomitant PCI and PTRAS can improve LVH and decrease the incidence of adverse events more than PCI alone. This study highlights the beneficial effect of ARAS revascularization, as a new and more aggressive revascularization strategy for such high-risk patients.

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Section: Discussionsupporting

confidence: 91%

Concomitant coronary and renal revascularization improves left ventricular hypertrophy more than coronary stenting alone in patients with ischemic heart and renal disease

Dong

Huang

Luo

et al. 2016

J. Zhejiang Univ. Sci. B

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“…These atherosclerotic renal artery lesions are usually found at the ostium or in the proximal third of this vessel [4,5].…”

Section: Detectionmentioning

confidence: 99%

Detection of main renal artery stenosis using phase-contrast cine MR angiography.

Silverman

Friedman²,

Allan³

1996

American Journal of Roentgenology

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“…In patients with fibromuscular dysplasia, progression of the lesion was noted at a rate between 16-38% (25)(26)(27), while total occlusion of the renal artery occurred rarely (28). In the case of atherosclerotic stenosis, on the other hand, lesion progression has been reported in 36-63% of the patients (23)(24)(25)27); total vessel occlusion was also observed relatively often (10-16%) during follow-up ranging from 6 months to more than 7 years.…”

Section: Discussionmentioning

confidence: 96%

Percutaneous Transluminal Renal Angioplasty in Patients with Renovascular Hypertension: Long-Term Results.

et al. 1995

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This study evaluated the long-term effects of percutaneous transluminal renal angioplasty (PTRA) on blood pressure and renal function in patients with renovascular hypertension. Seventy-eight patients with hypertension and unilateral or bilateral stenoses of the renal arteries (16 with fibromuscular dysplasia and 62 with atherosclerosis) were studied. All patients with fibromuscular dysplasia (group A) had normal renal function, while 27 of the 62 patients with atherosclerosis (group B) presented with various degrees of renal failure. PTRA was technically successful in 87.5% patients of group A. The overall technical success rate (complete plus partial) was 72.3% (55/76 renal arteries) in group B. Mean follow-up (range) in months was 42 (12-108) for group A and 39 (13-106) for group B. After successful PTRA, the overall benefit rate (cure plus improved) for hypertension was 100% in group A; 10 of 14 patients were cured and 4 of 14 were improved. In group B, the overall benefit rate was 70.8% ; 9 of 48 were cured and 25 of 48 were improved. PTRA was technically successful in 18 of 27 patients with renal failure. Renal function improved in 4 of 18 patients, remained stable in 9 of 18, and deteriorated in 5 of 18 patients. The above results suggest that PTRA is an effective method for the long-term management of patients with renovascular hypertension, although the results were less favorable in the presence of bilateral renal artery stenoses: in addition to improved control of blood pressure, PTRA might improve renal function or delay its progressive deterioration. (Hypertens Res 1995; 18: 27-31)

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Renovascular Hypertension. Anatomic and Remal Function Changes During Drug Therapy

Cited by 68 publications

References 0 publications

Concomitant coronary and renal revascularization improves left ventricular hypertrophy more than coronary stenting alone in patients with ischemic heart and renal disease

Concomitant coronary and renal revascularization improves left ventricular hypertrophy more than coronary stenting alone in patients with ischemic heart and renal disease

Detection of main renal artery stenosis using phase-contrast cine MR angiography.

Percutaneous Transluminal Renal Angioplasty in Patients with Renovascular Hypertension: Long-Term Results.

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