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08:21
A Modified Two Kidney One Clip Mouse Model of Renin Regulation in Renal Artery Stenosis
Published on: October 26, 2020
Revascularization versus medical therapy for renal-artery stenosis
The New England Journal of Medicine
|November 13, 2009
Summary
Percutaneous revascularization for atherosclerotic renovascular disease shows significant risks without clear clinical benefit. Medical therapy alone is a viable option, with similar outcomes for renal and cardiovascular events.
Area of Science:
- Cardiovascular Medicine
- Nephrology
- Interventional Cardiology
Background:
- Atherosclerotic renovascular disease (ARVD) affects renal artery patency through revascularization.
- Clinical benefit evidence for ARVD revascularization remains limited.
Purpose of the Study:
- To evaluate the clinical benefit of percutaneous revascularization in patients with ARVD.
- To compare renal function, blood pressure, and clinical events between revascularization and medical therapy alone.
Main Methods:
- A randomized, unblinded trial involving 806 patients with ARVD.
- Patients were assigned to either revascularization plus medical therapy or medical therapy alone.
- Primary outcome: renal function (reciprocal of serum creatinine); Secondary outcomes: blood pressure, renal/cardiovascular events, mortality. Median follow-up: 34 months.
Main Results:
- Revascularization showed a trend toward slower renal impairment progression (P=0.06) but no significant difference in mean serum creatinine levels.
- No significant differences were observed in systolic blood pressure, renal events, major cardiovascular events, or mortality between groups.
- Revascularization carried substantial risks, including 2 deaths and 3 amputations.
Conclusions:
- Percutaneous revascularization in ARVD patients presents significant risks.
- The study found no evidence of a worthwhile clinical benefit from revascularization compared to medical therapy alone.
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