Ischemic nephropathy: proteinuria and renal resistance index could suggest if revascularization is recommended.
BACKGROUND
The aim of endovascular therapy in renal artery stenosis (RAS) is to preserve renal function and have a better hypertension control. The purpose of our study was to determine which biochemical and instrumental parameters could predict a better renal outcome in patients with RAS treated with percutaneous transluminal angioplasty and stenting (RPTAS).


METHODS
We performed an observational study based on 40 patients with RAS who met the following criteria before revascularization: urinary protein excretion of over 250 mg/24 h, normal renal function, and/or mild-moderate renal insufficiency (I, II, and III levels of classification of chronic kidney disease, K-DOQI).


RESULTS
Assessment at 12 months after RPTAS showed in 20 patients (Group A) that proteinuria serum creatinine (Scr) and creatinine clearance (CrCl) significantly worsened from the baseline; whereas in 20 patients (Group B) proteinuria remained unchanged and the renal function improved after the procedure.


CONCLUSIONS
In our study, the decline of renal function after RPTAS is associated with an elevated renal resistance index (RI) in both kidneys (0.83 ± 0.2) and preexisting proteinuria.
Department of Nephrology, Sapienza University of Rome, Rome, Italy. ciancirosario@tin.it
Rosario
R
Cianci
Paola
P
Martina
Matteo
M
Cianci
Raffaella
R
Lavini
Gilda
G
Stivali
Domenico
D
Di Donato
Lelio
L
Polidori
Silvia
S
Lai
Roberta
R
Renzulli
Antonietta
A
Gigante
Biagio
B
Barbano
D000368:Aged; D017130:Angioplasty; D050197:Atherosclerosis / Q000628:therapy; D001783:Blood Flow Velocity; D003404:Creatinine / Q000097:blood; D018450:Disease Progression; D005260:Female; D018056:Hemorheology; D006801:Humans; D008297:Male; D008875:Middle Aged; D011507:Proteinuria / Q000150:complications / Q000601:surgery; D012078:Renal Artery Obstruction / Q000150:complications / Q000628:therapy*; D015607:Stents
D003404:Creatinine