title: Distal embolic protection during renal artery stenting: impact on hypertensive patients with renal dysfunction.
abstract: Distal embolic protection (DEP) may prevent embolization of atherosclerotic debris during renal artery stenting. The authors retrospectively identified 48 hypertensive patients with chronic kidney disease (CKD) who underwent renal artery stenting between 2002 and 2005 and compared stenting alone (n=17) to stenting/DEP (n=31). Blood pressure (BP) and estimated glomerular filtration rate (eGFR) (mL/min/1.73m(2)) at baseline at 6 and 12 months were compared. Overall, eGFR improved by 4.7 (P=.005) at 6 months and 3.8 (P=.003) at 12 months compared with baseline. Comparing stent to stent/DEP patients, eGFR improvement did not differ at 6 months (7.6 vs 2.9; P=.15) or at 12 months (4.4 vs 3.5; P=.74). Systolic BP reduction was similar between stent and stent/DEP patients at 6 months (-9 vs -14 mm Hg; P=.59) and at 12 months (-18 vs -16 mm Hg; P=.89). Renal artery stenting improved eGFR and systolic BP in patients with hypertension and CKD; however, DEP did not enhance these effects.
authors.affiliation: Section of Cardiovascular Medicine, Department of Internal Medicine, Yale University School of Medicine, New Haven, CT 06520-8017, USA. gregory.singer@yale.edu
authors.forename: Gregory M
authors.initials: GM
authors.lastname: Singer
authors.forename: John F
authors.initials: JF
authors.lastname: Setaro
authors.forename: Jeptha P
authors.initials: JP
authors.lastname: Curtis
authors.forename: Michael S
authors.initials: MS
authors.lastname: Remetz
mesh_terms: D000368:Aged; D001794:Blood Pressure; D002318:Cardiovascular Diseases / Q000503:physiopathology; D015331:Cohort Studies; D017023:Coronary Angiography; D004617:Embolism / Q000517:prevention & control* / Q000601:surgery; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D006978:Hypertension, Renovascular / Q000503:physiopathology*; D007676:Kidney Failure, Chronic / Q000503:physiopathology*; D008297:Male; D012078:Renal Artery Obstruction / Q000503:physiopathology / Q000601:surgery*; D012189:Retrospective Studies; D012307:Risk Factors; D015607:Stents; D013599:Systole