Research of multiarterial atherosclerotic disease in hypertensive patients with renal artery stenosis

Neves, Precil Diego Miranda de Menezes; Oliveira, A.A. de; Oliveira, Marcela Cristina de; Machado, Juliana Reis; Reis, Marlene Antônia dos; Mendonça, Helena Moisés; Resende, Luiz Antônio Pertili Rodrigues de; Marques, Vilmar de Paiva

doi:10.5935/0101-2800.20120005

Cited by 1 publication

(1 citation statement)

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“…Studies have shown that the advanced age, hypertension, hyperlipidemia, diabetes mellitus, renal insufficiency and peripheral vascular disease are high-risk factors of atherosclerotic renal artery stenosis (ARAS), and ARAS has a relatively high prevalence rate in cardiovascular diseases (3–8). ARAS causes a decrease in renal blood flow, which activates the renin-angiotensin system, leading to elevated blood pressure, whereas progressive lumen stenosis may lead to renal ischemia, causing progressive renal parenchymal damage, decreased renal function and ultimately leading to renal failure (9,10). …”

Section: Introductionmentioning

confidence: 99%

Percutaneous renal artery stent implantation in the treatment of atherosclerotic renal artery stenosis

Hu¹,

Zhang²,

Wang³

et al. 2018

Exp Ther Med

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We aimed to investigate the clinical curative effect of percutaneous renal artery stent implantation (PTRAS) in the treatment of atherosclerotic renal artery stenosis (ARAS), and to analyze the factors influencing the curative effect of PTRAS. A total of 230 patients with unilateral or bilateral renal artery stenosis were retrospectively analyzed. According to whether adverse cardiogenic or nephrogenic events occurred, 230 patients were divided into two groups to analyze the risk factors of adverse cardiogenic or nephrogenic events. The blood pressure of patients at each time-point after operation was decreased significantly compared with that before operation (P<0.01). The levels of serum creatinine (SCr) at 24 h and 36 months after PTRAS were slightly increased compared with that before operation (P>0.05). The estimated glomerular filtration rate (eGFR) at each time-point after operation was slightly decreased compared with that before operation, but the difference was not statistically significant (P>0.05). Renography showed that GFR on the side of stent implantation at 36 months after PTRAS had no significant change compared with that before operation (P>0.05), but GFR on the unaffected side without receiving PTRAS was significantly increased compared with that before operation (P=0.0014). During the 36-month follow-up, there were a total of 56 cases of adverse cardiogenic or nephrogenic events. Multivariate regression analysis results showed that adverse cardiogenic or nephrogenic events after PTRAS were obviously associated with age (≥65 years old), Charlson comorbidity index (CCI) score (≥2 points), diabetes mellitus, stroke and congestive heart failure (CHF) (P<0.05). In conclusion, PTRAS can effectively control the blood pressure and reduce the types of antihypertensive drugs used by patients with ARAS, but it has no definitely protective effect on renal function. Age (≥65 years old), CCI score (≥2 points), diabetes mellitus, stroke and CHF are risk factors leading to adverse cardiogenic or nephrogenic events after PTRAS.

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