Diabetes mellitus does not preclude stabilization or improvement of renal function after stent revascularization in patients with kidney insufficiency and renal artery stenosis.
OBJECTIVE
To assess the impact of stent revascularization on the renal function of diabetic and nondiabetic patients with renal insufficiency.


BACKGROUND
Renal artery revascularization has been shown to stabilize or improve renal function in patients with significant renal artery stenosis and impaired renal function. However, some studies have suggested negligible or no benefit of renal function in diabetic patients with the same condition.


METHODS
We retrospectively compared data from 50 consecutive patients undergoing renal artery stent placement with renal insufficiency (serum creatinine > or = 1.5-4.0 mg/dl) and global ischemia (bilateral or solitary [single] kidney renal artery stenosis) There were 17 diabetic (DM) and 33 nondiabetic (NDM) patients. The endpoints included the follow-up measurements of renal function, blood pressure, and number of antihypertensive medications.


RESULTS
After stent placement, at a mean follow-up of 42 +/- 18 months (range: 6-62 months), 79% NDM (N = 26), and 76% DM patients (N = 13) (P = NS) had improvement in the slope of the reciprocal of creatinine (1/SCr), indicating a beneficial effect in renal function in many patients.


CONCLUSIONS
Renal artery stent placement appears to be equally beneficial in preserving renal function in DM and NDM patients with ischemic nephropathy and global renal ischemia.
Silva
Jose A
JA
Department of Cardiology, Ochsner Clinic Foundation, New Orleans, Louisiana, USA. drsilva@tcaway.com
Potluri
Srinivas
S
White
Christopher J
CJ
Collins
Tyrone J
TJ
Jenkins
J Stephen
JS
Subramanian
Rajesh
R
Ramee
Stephen R
SR
D000368:Aged; D053099:Azotemia / Q000209:etiology / Q000503:physiopathology; D001794:Blood Pressure; D003404:Creatinine / Q000097:blood; D003928:Diabetic Nephropathies / Q000097:blood / Q000503:physiopathology / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007511:Ischemia / Q000097:blood / Q000150:complications* / Q000209:etiology / Q000503:physiopathology / Q000601:surgery; D007668:Kidney / Q000098:blood supply / Q000503:physiopathology*; D007677:Kidney Function Tests; D008297:Male; D012078:Renal Artery Obstruction / Q000097:blood / Q000150:complications / Q000503:physiopathology / Q000601:surgery*; D051436:Renal Insufficiency, Chronic / Q000097:blood / Q000209:etiology* / Q000503:physiopathology / Q000601:surgery; D012107:Research Design; D012189:Retrospective Studies; D012720:Severity of Illness Index; D015607:Stents; D013997:Time Factors; D016896:Treatment Outcome; D014656:Vascular Surgical Procedures / Q000295:instrumentation*
D003404:Creatinine