title: [Renal artery stenosis: angioplasty or drug treatment?].
abstract: OBJECTIVE
  Angioplasty in patients with renal artery stenosis aims at reducing blood pressure and at improving kidney function. Its efficacy has however been questioned by recent published data. It was the aim of this retrospective study to compare angioplasty with medical treatment in an unselected patient population.
  
  
  METHODS
  Data on 109 patients were retrospectively analysed. This cohort included all those patients admitted to the Lippe-Detmold Hospital between 1992 and 2008 for renal artery stenosis. The data included blood pressure, creatinine-based calculated glomerular filtration rate (cGFR), any renal dialysis, cardiovascular risk factors, events and survival time after transluminal renal angioplasty or drug treatment, respectively.
  
  
  RESULTS
  Patients who had undergone angioplasty were younger (p = 0.04), had less cardiovascular co-morbidity (p < 0.01), but a higher degree of stenosis (p < 0.01). After a median follow-up of 32.5 (angioplasty) and 36.0 months (drug treatment), respectively, a significant decrease of cGFR was recorded in drug treated patients (- 16.2 ml/min, 95 %, CI - 25.7 to - 6.7) but not in the angioplasty group (- 4.5 ml/min, 95 %, CI - 13.5 to 4.5). There were no other significant differences were not observed.
  
  
  CONCLUSIONS
  Younger patients with a high degree of renal artery stenosis but without generalized atherosclerosis more frequently underwent angioplasty in clinical practice. The smaller post-angioplasty reduction in the loss of renal function in this group needs to be validated in a prospective, randomized study.
authors.affiliation: Abteilung Nephrologie und Rheumatologie, Universitätsmedizin Göttingen.
authors.forename: C
authors.initials: C
authors.lastname: Bramlage
authors.forename: A
authors.initials: A
authors.lastname: Cuneo
authors.forename: D
authors.initials: D
authors.lastname: Härtel
authors.forename: K
authors.initials: K
authors.lastname: Jung
authors.forename: C-H
authors.initials: CH
authors.lastname: Witteck
authors.forename: R
authors.initials: R
authors.lastname: Högel
authors.forename: G A
authors.initials: GA
authors.lastname: Müller
authors.forename: P
authors.initials: P
authors.lastname: Bramlage
authors.forename: U
authors.initials: U
authors.lastname: Tebbe
mesh_terms: D000368:Aged; D017130:Angioplasty; D000925:Anticoagulants / Q000627:therapeutic use*; D000959:Antihypertensive Agents / Q000627:therapeutic use*; D001241:Aspirin / Q000627:therapeutic use*; D001794:Blood Pressure / Q000187:drug effects / Q000502:physiology; D002318:Cardiovascular Diseases / Q000150:complications; D000077144:Clopidogrel; D015331:Cohort Studies; D003131:Combined Modality Therapy; D003404:Creatinine / Q000097:blood; D003952:Diagnostic Imaging; D005260:Female; D005500:Follow-Up Studies; D005858:Germany; D005919:Glomerular Filtration Rate / Q000187:drug effects / Q000502:physiology; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D006978:Hypertension, Renovascular / Q000150:complications / Q000175:diagnosis / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D012078:Renal Artery Obstruction / Q000150:complications / Q000175:diagnosis / Q000628:therapy*; D006435:Renal Dialysis; D012189:Retrospective Studies; D012307:Risk Factors; D015996:Survival Rate; D013988:Ticlopidine / Q000031:analogs & derivatives* / Q000627:therapeutic use
chemical_list: D000925:Anticoagulants; D000959:Antihypertensive Agents; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D000077144:Clopidogrel; D003404:Creatinine; D013988:Ticlopidine; D001241:Aspirin