Impact of baseline renal function on outcomes of renal artery stenting in hypertensive patients.
Renal artery stenting may improve blood pressure (BP) and renal function in resistant hypertension patients; however, benefit may differ depending on the degree of renal dysfunction. The authors analyzed 67 consecutive patients receiving stenting for obstructive renal artery disease between 2002 and 2005. Patients were categorized as normal or mildly impaired according to estimated glomerular filtration rate (eGFR) (> or =60 mL/min/1.73 m(2)), moderately impaired (eGFR 30 to 59 mL/min/1.73 m(2)), and severely impaired (eGFR <30 mL/min/1.73 m(2)). In patients with eGFR > or =60, systolic BP did not significantly improve from baseline. However, in patients with an eGFR between 30 and 59 mL/min/1.73 m(2), systolic BP decreased by 12 mm Hg at 6 months (P=.02) and 14 mm Hg at 12 months (P=.01). Greater benefit was observed in patients with eGFR <30 mL/min/1.73 m(2), with a 16 mm Hg (P=.10) and 21 mm Hg (P=.02) decrease at 6 and 12 months, respectively. Renal function was stable across all groups. Renal artery stenting reduced BP and produced greatest benefit in patients with baseline impaired renal function.
Singer
Gregory M
GM
Department of Internal Medicine, Yale University of School of Medicine, New Haven, CT 06520-8017, USA.
Remetz
Michael S
MS
Curtis
Jeptha P
JP
Setaro
John F
JF
D000368:Aged; D000369:Aged, 80 and over; D001794:Blood Pressure / Q000502:physiology; D003404:Creatinine / Q000097:blood; D005260:Female; D005919:Glomerular Filtration Rate / Q000502:physiology; D006801:Humans; D006977:Hypertension, Renal / Q000503:physiopathology / Q000628:therapy*; D007668:Kidney / Q000098:blood supply / Q000503:physiopathology*; D008297:Male; D011379:Prognosis; D012077:Renal Artery / Q000503:physiopathology*; D012189:Retrospective Studies; D015607:Stents; D016896:Treatment Outcome
D003404:Creatinine