Angioplasty and STent for Renal Artery Lesions (ASTRAL trial): rationale, methods and results so far

Mistry, Sarah J.; Ives, Natalie; Harding, J. W.; Fitzpatrick-Ellis, K.; Lipkin, Graham; Kalra, Philip A.; Moss, Jonathan; Wheatley, Keith

doi:10.1038/sj.jhh.1002185

Cited by 87 publications

(48 citation statements)

References 9 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Large-scale randomized trials will determine whether or not revascularization is indeed superior to medical treatment [127, 128]. The results of these trials are expected to provide more reliable evidence regarding the optimal treatment options.…”

Section: Literature Search Resultsmentioning

confidence: 99%

Atherosclerotic Renal Artery Stenosis: Association with Emerging Vascular Risk Factors

Paraskevas¹,

Hamilton

Cross

et al. 2007

Nephron Clin Pract

View full text Add to dashboard Cite

Background: The established risk factors for atherosclerotic renal artery stenosis (ARAS) include hypertension, diabetes mellitus, dyslipidemia, obesity,smoking, old age and family history. In the last few years, several emerging risk factors have been proposed as predictors of ARAS, namely homocysteine, fibrinogen, C-reactive protein, lipoprotein(a) and creatinine. Methods: We searched Pubmed/Medline for studies investigating the prognostic value of each of these emerging risk factors in ARAS. Results: Creatinine and C-reactive protein seem to be the most promising predictors of ARAS, whereas the prognostic value of homocysteine, lipoprotein(a) and fibrinogen is not yet fully determined. Conclusion: The establishment of a definite role for these emerging risk factors could result in earlier recognition and/or better management of ARAS with potential regression/slowing down of progression of stenosis. Modifying these markers may also improve the therapeutic approach of the associated systemic atherosclerosis in these high-risk patients. Future trials should focus on the effect of different classes of drugs (e.g. statins and fibrates) on the levels of the emerging risk factors and the association with ARAS progression.

show abstract

Section: Literature Search Resultsmentioning

confidence: 99%

Atherosclerotic Renal Artery Stenosis: Association with Emerging Vascular Risk Factors

Paraskevas¹,

Hamilton

Cross

et al. 2007

Nephron Clin Pract

View full text Add to dashboard Cite

show abstract

“…43 Furthermore, several clinical trials have validated renal angioplasty and stenting in treating renal artery stenosis, especially in high-risk patients with recurrent flash pulmonary edema. [229][230][231] Controversy exists as to whether kidney reoxygenation through this surgery is superior to that induced by medical therapy. Nevertheless, the goal of both strategies is to correct renal hypoxia.…”

Section: Air Pollutionmentioning

confidence: 99%

Hypoxia: The Force that Drives Chronic Kidney Disease

Colgan

Shelley

2016

Clinical Medicine & Research

120

111

View full text Add to dashboard Cite

In the United States the prevalence of end-stage renal disease (ESRD) reached epidemic proportions in 2012 with over 600,000 patients being treated. The rates of ESRD among the elderly are disproportionally high. Consequently, as life expectancy increases and the baby-boom generation reaches retirement age, the already heavy burden imposed by ESRD on the US health care system is set to increase dramatically. ESRD represents the terminal stage of chronic kidney disease (CKD). A large body of evidence indicating that CKD is driven by renal tissue hypoxia has led to the development of therapeutic strategies that increase kidney oxygenation and the contention that chronic hypoxia is the final common pathway to end-stage renal failure. Numerous studies have demonstrated that one of the most potent means by which hypoxic conditions within the kidney produce CKD is by inducing a sustained inflammatory attack by infiltrating leukocytes. Indispensable to this attack is the acquisition by leukocytes of an adhesive phenotype. It was thought that this process resulted exclusively from leukocytes responding to cytokines released from ischemic renal endothelium. However, recently it has been demonstrated that leukocytes also become activated independent of the hypoxic response of endothelial cells. It was found that this endothelium-independent mechanism involves leukocytes directly sensing hypoxia and responding by transcriptional induction of the genes that encode the β2-integrin family of adhesion molecules. This induction likely maintains the long-term inflammation by which hypoxia drives the pathogenesis of CKD. Consequently, targeting these transcriptional mechanisms would appear to represent a promising new therapeutic strategy.

show abstract

“…in the presence of significant renal artery stenosis, treatment should be based on current guidelines. [57][58][59][60][61] Aortic Aneurysm Disease the prevalence of aneurysms in patients with Cli is 12%. 62 in patients with Pad, an aneurysm is present in 11-14% of men and 6% of women for a total prevalence of 4-9%.…”

Section: Renal Artery Diseasementioning

confidence: 99%

Critical Limb Ischemia: Advanced Medical Therapy

Davies

2012

Methodist DeBakey Cardiovascular Journal

View full text Add to dashboard Cite

Angioplasty and STent for Renal Artery Lesions (ASTRAL trial): rationale, methods and results so far

Cited by 87 publications

References 9 publications

Atherosclerotic Renal Artery Stenosis: Association with Emerging Vascular Risk Factors

Atherosclerotic Renal Artery Stenosis: Association with Emerging Vascular Risk Factors

Hypoxia: The Force that Drives Chronic Kidney Disease

Critical Limb Ischemia: Advanced Medical Therapy

Contact Info

Product

Resources

About