Outcome of blood pressure and renal function in patients with renal artery stenosis after stenting
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Ashish Anil Sule1, Dessmon Yh Tai, Siew Pang Chan
1Departments of General Medicine, Respiratory Medicine, and Clinical Research Unit, Tan Tock Seng Hospital, Singapore.
Insights
Renal artery stenting significantly improves blood pressure in stenosis patients. Renal function stabilizes or improves in non-diabetic individuals, but may decline in diabetic patients.
Area of Science:
- Cardiovascular Medicine
- Nephrology
- Interventional Cardiology
Background:
- Renal artery stenosis (RAS) is a significant cause of secondary hypertension and progressive renal damage.
- Stenting is a common intervention for RAS, but its long-term effects on blood pressure and renal function require ongoing evaluation.
Purpose of the Study:
- To assess the impact of renal artery stenting on systolic and diastolic blood pressure (BP).
- To evaluate changes in renal function, specifically serum creatinine levels, post-stenting.
- To analyze these effects at multiple time points: three months, six months, one year, and last follow-up.
Main Methods:
- Analysis of 32 patients with significant RAS who underwent angioplasty with stenting between 1999 and 2006.
- Systematic recording of BP and serum creatinine at baseline and follow-up intervals.
- Application of generalized estimating equations to analyze temporal changes in BP and renal function.
Main Results:
- Significant improvements in both systolic and diastolic BP were observed at all follow-up points compared to baseline.
- Patients without diabetes mellitus (DM) showed stable or improved serum creatinine levels, with improvement noted at one year.
- Patients with DM experienced a deterioration in serum creatinine levels.
Conclusions:
- Renal artery stenting leads to significant BP reduction in patients with RAS.
- Renal function is generally preserved or improved in non-diabetic patients post-stenting.
- Diabetic patients, particularly those with proteinuria, face a risk of renal function decline despite stenting.
Objective:
To study the response of systolic and diastolic blood pressure (BP) and renal function after renal artery stenting at three months, six months, one year and last follow-up.
Methods:
Patients with significant renal artery stenosis who underwent angioplasty with stenting from January 1999 to September 2006 were analyzed. The BP and serum creatinine levels were recorded at baseline, three months, six months, one year and at last follow-up. Generalized estimating equations were applied to analyze the changes in blood pressure and serum creatinine over time.
Results:
There were 32 patients - 21 Chinese, six Malay and five Indian. The male to female ratio was 1.3:1. The mean age (± SD) was 69.4±8.8 years. The mean follow-up time was 1.8±1.6 years (range 0.5 to six years). When compared with the baseline BP, there was significant improvement at three months, six months, one year and at last follow-up. In the diabetes mellitus (DM) group, there was deterioration in serum creatinine. In the non-DM group, there was stabilization of serum creatinine with improvement at one year.
Conclusion:
Significant improvement in BP occurs in renal artery stenosis patients after stenting. In patients without DM, renal function remains stable or improves. However, in DM patients, especially those with proteinuria, there is deterioration in renal function.
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