Efficacy of renal artery angioplasty and stenting in a solitary functioning kidney.
OBJECTIVE
The aim of this study was to share our experience of percutaneous renal artery angioplasty and stenting (PTRAS) in our patients with a solitary functioning kidney over a 10-year period.


METHODS
The procedures were performed on 75 patients from 1995 to 2004. Data were collected retrospectively from case notes of patients. The definition for solitary functioning kidney was a contralateral kidney size of <8 cm, complete occlusion of contralateral renal artery or previous nephrectomy. Serum creatinine was considered improved or worse if the deviation from the baseline value was >20%.


RESULTS
For the purpose of halting renal deterioration (n=47), there were improvement and stabilization in 21% and 55% at 3 months and 28% and 28% at 12 months. Systolic blood pressure (n=27) improvement and stabilization were achieved in 33% and 56% both at 3 and 12 months. Diastolic blood pressure (n=27) improvement and stabilization were 22% and 70% at 3 months and 33% and 48% at 12 months. Five out of seven patients with acute renal failure (serum creatinine>500 micromol/l and requiring haemodialysis) pre-procedure were dialysis-free at 12 months. Complications occurred in 19 (25%) patients and these included bleeding (n=16), pseudoaneurysm (n=3), renal artery dissection (n=2) and cholesterol embolization (n=1).


CONCLUSIONS
PTRAS in a solitary functioning kidney produced clinical benefits in the majority of patients with resistant hypertension and renal function deterioration.
Tan
Jackson
J
Leeds General Infirmary, Great George Street, Leeds LS1 3EX, UK. jcstan1810@yahoo.co.uk
Filobbos
Rafik
R
Raghunathan
Girish
G
Nicholson
Tony
T
Fowler
Richard
R
Wright
Mark
M
Eadington
David
D
D058186:Acute Kidney Injury / Q000209:etiology / Q000503:physiopathology; D000368:Aged; D017130:Angioplasty / Q000009:adverse effects; D001794:Blood Pressure; D003971:Diastole; D006801:Humans; D006973:Hypertension / Q000209:etiology / Q000503:physiopathology; D007668:Kidney / Q000503:physiopathology*; D008875:Middle Aged; D012077:Renal Artery; D012078:Renal Artery Obstruction / Q000150:complications / Q000401:mortality / Q000503:physiopathology* / Q000628:therapy*; D012189:Retrospective Studies; D015607:Stents / Q000009:adverse effects; D013599:Systole; D013997:Time Factors; D016896:Treatment Outcome