title: The association between renal atherosclerotic plaque characteristics and renal function before and after renal artery intervention.
abstract: OBJECTIVE
  To evaluate the effect of plaque composition on renal function after renal artery intervention (RAI).
  
  
  METHODS
  In 33 consecutive patients with atherosclerotic renal artery stenosis (enrolled between January 1, 2007, and April 30, 2009), renal angiography, pressure gradients across the lesion, and intravascular ultrasonography (IVUS) with virtual histology (VH)-derived plaque characteristics were assessed. In 25 patients who underwent RAI, estimated glomerular filtration rate (eGFR) was evaluated at baseline and at 3 months.
  
  
  RESULTS
  Mean pressure gradients across the lesion were poorly associated with baseline eGFR (r=-0.37; P=.07). In gray scale IVUS data, only remodeling index was significantly correlated with baseline eGFR (r=-0.38; P=.03). Plaque components classified by VH-IVUS had no correlation with baseline eGFR. During follow-up of 25 patients, the improvement in eGFR after RAI was observed in 9 patients, unchanged in 3, and deteriorated in 13. Overall, follow-up eGFR (median, 49.0 mL/min/1.73 m(2); interquartile range [IQR], 40.6-63.9 mL/min/1.73 m(2)) was unchanged compared with baseline eGFR (median, 53.8 mL/min/1.73 m(2); IQR, 41.4-63.4 mL/min/1.73 m(2); P=.38). The percent change in eGFR (median, -0.2%; IQR, -16.0% to 16.0%) after RAI had a significant negative correlation with the mean percentage of necrotic core classified by VH-IVUS (r=-0.47; P=.02), and the mean percentage of necrotic core was significantly larger in patients with deterioration of eGFR than in patients without deterioration of eGFR (median, 12.7%; IQR, 9.5%-19.5%; vs median, 8.3%; IQR, 5.5%-11.6%; P=.04).
  
  
  CONCLUSIONS
  In patients with atherosclerotic renal artery stenosis, the change in eGFR after RAI was related to plaque composition classified by VH-IVUS. The evaluation of plaque composition may provide more insights into the change in renal function after RAI.
authors.affiliation: Division of Cardiovascular Diseases, Mayo Clinic, Rochester, MN 55905, USA. lerman.amir@mayo.edu
authors.forename: Takuro
authors.initials: T
authors.lastname: Takumi
authors.forename: Verghese
authors.initials: V
authors.lastname: Mathew
authors.forename: Gregory W
authors.initials: GW
authors.lastname: Barsness
authors.forename: Tetsuro
authors.initials: T
authors.lastname: Kataoka
authors.forename: Ronen
authors.initials: R
authors.lastname: Rubinshtein
authors.forename: Charanjit S
authors.initials: CS
authors.lastname: Rihal
authors.forename: Rajiv
authors.initials: R
authors.lastname: Gulati
authors.forename: Eric
authors.initials: E
authors.lastname: Eeckhout
authors.forename: Ryan J
authors.initials: RJ
authors.lastname: Lennon
authors.forename: Lilach O
authors.initials: LO
authors.lastname: Lerman
authors.forename: Amir
authors.initials: A
authors.lastname: Lerman
mesh_terms: D000368:Aged; D000792:Angiography; D005260:Female; D005500:Follow-Up Studies; D005919:Glomerular Filtration Rate / Q000502:physiology*; D006801:Humans; D007668:Kidney / Q000503:physiopathology*; D008297:Male; D058226:Plaque, Atherosclerotic / Q000150:complications / Q000503:physiopathology* / Q000601:surgery; D057234:Preoperative Period; D011379:Prognosis; D012077:Renal Artery; D012078:Renal Artery Obstruction / Q000209:etiology / Q000503:physiopathology* / Q000601:surgery; D012189:Retrospective Studies; D012307:Risk Factors; D018084:Ultrasonography, Interventional; D014656:Vascular Surgical Procedures