Renal artery stent in solitary functioning kidneys

Abstract

Background:Solitary functioning kidney (SFK) is tough issue to address in clinical, mostly developed from renal artery stenosis (RAS) in adults. Although renal artery stent is widely used to help SFK patients, the efficacy of the stent is still disputable. This study is aimed at reviewing a series of SFK cases to draw a conclusion about the efficacy of renal artery stent.Methods:All related papers published in PubMed, Web of Science, EMBASE, and Cochrane Library were searched. Studies or subsets were included only if they satisfied certain criteria. The benefit rate which equaled the rate of improvement subjoining the rate of stabilization was calculated. All analyses were conducted with Stata version 12.0 (Stata Corporation, College Station, TX).Results:According to 7 papers on the efficacy of renal artery stent, 253 SFK patients were included. The result revealed that the renal artery stent could help SFK patients to improve or stabilize their renal function (RF). The benefit rate was 0.77, with 95% confidence interval between 0.72 and 0.83.Conclusions:With proper patient selection, renal artery stent could benefit SFK patients with a percentage odd of 0.77 to improve or stabilize the RF.

Severe acute kidney injury in a patient with renal artery stenosis of a single-functioning kidney: A case report of rapid normalisation of the renal function after percutaneous transluminal angioplasty with stent placement

“…When revascularization is considered, first-line treatment is angioplasty with stent placement, as angioplasty alone shows higher prevalence of restenosis with similar outcomes. 1,21,24,28,29 Major complications of stenting are specialist-and lesion-dependant; they occur in less than 5% of the cases and include bleeding, pseudoaneurysms, distal embolisation, acute kidney injury and acute renal artery occlusion or dissection, sometimes resulting in terminal renal replacement. 7,9,21,30 Interestingly, a systematic literature review made by Ma et al 21 concerning patients with a solitary functioning kidney concluded that up to 77% of the patients with a single-functioning kidney showed an improvement or stabilisation of their renal function after PTRA.…”

“… 9 – 13 In acute settings with rapidly progressive heart and renal failure, BMT versus revascularisation has been only rarely studied and some observational studies have shown improved outcomes in patients who underwent percutaneous transluminal renal angioplasty (PTRA) and stenting of the RAS. 13 – 20 Indeed, some subgroups of patients, including patients with a solitary functioning kidney, 20 – 23 could benefit from this more interventional approach.…”

Use of percutaneous transluminal renal angioplasty in atherosclerotic renal artery stenosis: a systematic review and meta-analysis

“…Additionally, renal events resulted from diabetes, nephritis, nephropathy, heart failure, and a solitary functioning kidney. In a previous meta-analysis, 39 7 studies focused on the efficacy of PTRA on patients with a solitary functioning kidney, involving 253 cases. This previous meta-analysis showed that a renal artery stent was beneficial for patients with a solitary functioning kidney regarding improved or stabilized renal function.…”

Effects of percutaneous angioplasty on kidney function and blood pressure in patients with atherosclerotic renal artery stenosis

“…There have been several studies reporting the benefits of revascularization in high-risk patients with ARAS [8,9,22,24]. Patients presenting with a combination of rapidly declining kidney function and refractory hypertension may benefit from revascularization [22].…”

“…Current guidelines for ARAS recommend PTA as a reasonable option for patients with haemodynamically significant RAS with clinical manifestations such as resistant hypertension, unexplained pulmonary edema, or progressive chronic kidney disease [7,8]. However, patient selection for renal revascularization is sometimes challenging, because limited comparative data are available on the specific phenotype of patients who would benefit from the procedure [9–11].…”