title: Baseline inflammatory status and long-term changes in renal function after percutaneous renal artery stenting: a prospective study.
abstract: OBJECTIVE
  To investigate a possible independent predictive role of systemic inflammation markers on renal function after renal artery stenting.
  
  
  BACKGROUND
  An elevated baseline serum creatinine has previously been shown to be the strongest predictor of improved renal function after percutaneous renal artery stenting. The inflammatory system is implicated in every stage of chronic kidney disease, and we hypothesized an additional value of markers of systemic inflammation in predicting response after renal artery stenting.
  
  
  METHODS
  This single center, prospective study includes 62 consecutive patients with chronic kidney disease at stage ≥ 3 or resistant hypertension who underwent stent placement for 74 angiographically significant atherosclerotic renal lesions. Inflammatory markers, including serum C-reactive protein (CRP), erythrocyte sedimentation rate, and white blood cell count were determined prior to renal angioplasty and related to changes in renal function at follow-up.
  
  
  RESULTS
  Six-month clinical follow up was completed in 57 patients. Overall, median serum creatinine concentration exhibited a non significant reduction from 1.40 mg/dl (quartiles: 1.20, 1.75 mg/dl) at baseline to 1.30 mg/dl (quartiles: 1.1, 1.55 mg/dl) at 6 months (p=0.17). Significant multivariate independent predictors of decreased creatinine included higher baseline serum creatinine levels (adjusted OR per quartile increment, 2.5 [1.3 to 4.7], p=0.004) and lower C-reactive protein levels (adjusted OR per quartile increment 0.39 [0.19 to 0.82], p=0.013).
  
  
  CONCLUSIONS
  Patients with higher serum creatinine and lower CRP derive the most benefit from renal artery stenting.
authors.affiliation: Institute of Cardiology, Catholic University of the Sacred Heart, Rome, Italy.
authors.forename: Carlo
authors.initials: C
authors.lastname: Trani
authors.forename: Italo
authors.initials: I
authors.lastname: Porto
authors.forename: Antonella
authors.initials: A
authors.lastname: Tommasino
authors.forename: Maura
authors.initials: M
authors.lastname: Giammarinaro
authors.forename: Francesco
authors.initials: F
authors.lastname: Burzotta
authors.forename: Giampaolo
authors.initials: G
authors.lastname: Niccoli
authors.forename: Antonio Maria
authors.initials: AM
authors.lastname: Leone
authors.forename: Santiago Federico
authors.initials: SF
authors.lastname: Coroleu
authors.forename: Giorgio
authors.initials: G
authors.lastname: Cautilli
authors.forename: Mario Attilio
authors.initials: MA
authors.lastname: Mazzari
authors.forename: Giovanni
authors.initials: G
authors.lastname: Schiavoni
authors.forename: Filippo
authors.initials: F
authors.lastname: Crea
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D017073:Atherectomy / Q000379:methods*; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007249:Inflammation / Q000097:blood / Q000473:pathology / Q000601:surgery; D007668:Kidney / Q000098:blood supply / Q000473:pathology / Q000601:surgery; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012078:Renal Artery Obstruction / Q000097:blood* / Q000473:pathology / Q000601:surgery*; D015607:Stents; D013997:Time Factors