Stenting and cell technologies in the treatment of atherosclerotic renovascular hypertension Part 1. Effectiveness and safety of renal artery stenting in ischemic kidney disease

Abstract

Aim. To assess renal artery stenting (RAS) effectiveness and safety in patients with renovascular hypertension (RVH) duration over 10 years.Material and methods. Seventy-eight patients were randomized into main (n=26) and placebo groups (n=52). Primary end-point was systolic blood pressure (SBP) level. Secondary end-points included: restenosis incidence; glomerular filtration rate (GFR); effective renal plasma flow (ERPF); creatinine level and microalbuminuria (MAU); quality of life (QoL); renal biopsy and immuno-hystochemical assay data; renal vessel calcification; cerebral metabolism level.Results. RAS resulted in average BP decrease from 181/107 to 142/93 mm Hg; after 6 weeks, no patient achieved target BP levels. Restenosis at 12 months was observed in 17% of the patients from both groups; another RAS was needed in 8%. According to dynamic nephroscintigraphy results, GFR reduced by 5% (p<0,05), and ERPF - by 3% (p<0,05). Creatinine level decreased by 3% (p<0,01), and MAU - by 7% (p<0,05). Assessed by SF-36 questionnaire, QoL was normal in 14- 29% only.Conclusion. RAS remains an ineffective method of RVH treatment, even though it prevents renal artery thrombosis and improves RVH control to some extent.

Keywords

• ишемическая болезнь почек
• реноваскулярная гипертония
• стентирование почечных артерий