The benefit of renal artery stenting in patients with atheromatous renovascular disease and advanced chronic kidney disease

Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions
Philip A KalraThomas Zeller

Abstract

Around 16% of all patients who present with atheromatous renovascular disease (ARVD) in the United States undergo revascularization. Historically, patients with advanced chronic kidney disease (CKD) have been considered least likely to show improvement in renal functional terms, or survival. We aimed to investigate whether differences in outcomes after revascularization compared to medical management might be observed in ARVD patients if stratified by their CKD classes. Two prospective cohorts, a UK center with a traditionally conservative approach, and a German center who undertook a proactive revascularization approach, were compared. An improvement in renal function was defined as > 20% renal improvement at one year's follow-up. To improve validity and comparability, revascularized patients in the UK center were also used within analyses, 347 (UK conservative group), 89 (UK revascularized group), and 472 (German center) patients were included in the analysis. When subdivided by CKD stage, patient ages between the two centers were comparable. Improvements in renal function were observed in twice as many patients who underwent revascularization as compared to medical treatment, particularly in the latter CKD stages, 15.2 (Germ...Continue Reading

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Citations

Jan 29, 2011·European Heart Journal·Iris Baumgartner, Lilach O Lerman
Nov 16, 2012·Medical Devices : Evidence and Research·William R Colyer
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Jun 26, 2020·Integrated Blood Pressure Control·Rohini ManaktalaChristopher J White

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