Short-Term Renal Function Outcomes after Renal Artery Stenting in Atherosclerotic Renal Artery Stenosis

Year 2024, Volume: 77 Issue: 3, 239 - 242, 10.10.2024

Emre Utkan Büyükceran

Abstract

Objectives: Renal artery stenosis (RAS) poses significant challenges due to decreased renal perfusion, leading to various disease processes. We aimed
to evaluate the safety and effectiveness of renal artery stenting in patients with atherosclerotic RAS, focusing on early renal function changes and
identifying factors influencing treatment response.

Materials and Methods: This single-center, retrospective, observational study included patients undergoing renal artery stenting for atherosclerotic
RAS over a 10-year period. Clinical and procedural data were analyzed, and renal function outcomes were assessed at the 1-month follow-up.
Statistical analysis was performed to identify correlations between patient characteristics, procedural factors, and treatment outcomes.

Results: Forty-nine patients were included, with a mean age of 67.08±8.73 years. Successful stenting was achieved in all patients, with no major
adverse clinical events reported. At the 1-month follow-up, 67.3% of patients had stable renal function, while 12.2% showed improvement
and 20.4% experienced worsening. A significant correlation was found between age and treatment response (p=0.045). However, no significant
associations were observed between changes in renal function and other patient characteristics or procedural factors.

Conclusion: Renal artery stenting in patients with atherosclerotic RAS resulted in successful procedural outcomes with minimal complications.
While age was identified as a significant predictor of treatment response, no other patient or procedural factors showed significant correlations with
changes in renal function. Our findings emphasize the need for further research to refine patient selection criteria in this population.

Keywords

Renal artery stenosis , renal artery stenting , atherosclerotic RAS , renal function outcomes , patient selection

Ethical Statement

The study was carried out with the permission of Ankara University Faculty of Medicine Human Research Ethics Committee (date: 28.01.2023, approval no.: İ02- 73-23, registration no: 2023/40).

Supporting Institution

-

Project Number

-

Thanks

-

References

• 1. ASTRAL Investigators; Wheatley K, Ives N, et al. Revascularization versus medical therapy for renal-artery stenosis. N Engl J Med. 2009;361:1953- 1962.
• 2. Dobrek L. An Outline of Renal Artery Stenosis Pathophysiology-A Narrative Review. Life (Basel). 2021;11:208.
• 3. Przewłocki T, Kabłak-Ziembicka A, Tracz W, et al. Renal artery stenosis in patients with coronary artery disease. Kardiol Pol. 2008;66:863-864.
• 4. Guo H, Kalra PA, Gilbertson DT, et al. Atherosclerotic renovascular disease in older US patients starting dialysis, 1996 to 2001. Circulation. 2007;115:50-58.
• 5. Cheung CM, Wright JR, Shurrab AE, et al. Epidemiology of renal dysfunction and patient outcome in atherosclerotic renal artery occlusion. J Am Soc Nephrol. 2002;13:149-157.
• 6. Kalra PA, Guo H, Kausz AT, et al. Atherosclerotic renovascular disease in United States patients aged 67 years or older: risk factors, revascularization, and prognosis. Kidney Int. 2005;68:293-301.
• 7. Tafur JD, White CJ. Renal Artery Stenosis: When to Revascularize in 2017. Curr Probl Cardiol. 2017;42:110-135.
• 8. Wright JR, Duggal A, Thomas R, et al. Clinicopathological correlation in biopsy-proven atherosclerotic nephropathy: implications for renal functional outcome in atherosclerotic renovascular disease. Nephrol Dial Transplant. 2001;16:765-770.
• 9. Morganti A, Bencini C, Del Vecchio C, et al. Treatment of atherosclerotic renal artery stenosis. J Am Soc Nephrol. 2002;13(Suppl 3):187-189.
• 10. Meng X, Zhou Y, Jiang XJ, et al. Etiology spectrum and clinical characteristics of renal artery stenosis in a Chinese cohort. J Geriatr Cardiol. 2021;18:104- 113.
• 11. Bax L, Woittiez AJ, Kouwenberg HJ, et al. Stent placement in patients with atherosclerotic renal artery stenosis and impaired renal function: a randomized trial. Ann Intern Med. 2009;150:840-848.
• 12. Cooper CJ, Murphy TP, Cutlip DE, et al. Stenting and medical therapy for atherosclerotic renal-artery stenosis. N Engl J Med. 2014;370:13-22.
• 13. Gupta R, Syed M, Ashcherkin N, et al. Renal Artery Stenosis and Congestive Heart Failure: What Do We Really Know? Curr Cardiol Rep. 2019;21:74.