Renal angioplasty causes a rapid transient increase in inflammatory biomarkers, but reduced levels of interleukin-6 and endothelin-1 1 month after intervention.
OBJECTIVE
To examine prospectively whether inflammatory biomarkers and endothelin (ET)-1 are increased in patients with renal artery stenosis (RAS), and to investigate how treatment with percutaneous transluminal renal angioplasty (PTRA) affects these variables during the first month after intervention.


METHODS
One hundred patients with suspected RAS undergoing renal angiography were included. PTRA was performed if the trans-stenotic mean arterial pressure gradient was>or=10 mmHg. High-sensitivity C-reactive protein (hs-CRP), interleukin-6 (IL-6), tumor necrosis factor-alpha (TNFalpha), neopterin, CD40 ligand (CD40L) and endothelin-1 (ET-1) were measured before, and 1 day and 1 month after PTRA (n=61) or diagnostic angiography only (n=39).


RESULTS
At baseline there were no significant differences in inflammatory biomarkers or ET-1 levels between patients subsequently undergoing PTRA or angiography only. After angiography, IL-6 and hs-CRP had increased in both groups compared to baseline (P<0.001). At this time point hs-CRP (10.90+/-1.48 versus 6.37+/-1.61 mg/l; P<0.05) and IL-6 (13.70+/-0.94 versus 13.00+/-0.17 pg/ml; P<0.01) were higher in the PTRA group than in patients subjected to angiography only. One month after PTRA, systolic blood pressure and levels of IL-6 and ET-1 were lower than before intervention (P<0.05), whereas CD40L had increased compared to baseline (P<0.01).


CONCLUSIONS
In patients with RAS, PTRA triggers rapid transient increases in hs-CRP and IL-6; however, 1 month after PTRA, both IL-6 and ET-1 had decreased compared to before intervention, indicating beneficial effects of PTRA on inflammation and the endothelin system.
Alhadad
Alaa
A
University of Lund, Department of Vascular Diseases, Malmö University Hospital, Malmö, Sweden. alaa.alhadad@skane.se
Guron
Gregor
G
Fortuna-Nowakowska
Ella
E
Saeed
Aso
A
Mattiasson
Ingrid
I
Jensen
Gert
G
Lindblad
Bengt
B
Gottsäter
Anders
A
Herlitz
Hans
H
D000368:Aged; D017130:Angioplasty / Q000379:methods; D015415:Biomarkers / Q000097:blood*; D001794:Blood Pressure; D019332:Endothelin-1 / Q000097:blood*; D005260:Female; D006801:Humans; D007249:Inflammation / Q000378:metabolism*; D015850:Interleukin-6 / Q000097:blood*; D007668:Kidney / Q000098:blood supply* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged
D015415:Biomarkers; D019332:Endothelin-1; D015850:Interleukin-6