title: Blood pressure and renal function before and after percutaneous transluminal renal angioplasty in fibromuscular dysplasia: a cohort study.
abstract: OBJECTIVE
  To evaluate the long-term effects of percutaneous transluminal renal angioplasty (PTRA) on blood pressure and renal function in patients with fibromuscular dysplasia (FMD).
  
  
  METHODS
  Patients in whom FMD was diagnosed during renal angiography (n = 51) were compared with a matched group of hypertensive patients in whom angiography revealed normal renal arteries (n = 51). Blood pressure, intensity of antihypertensive medication and creatinine clearance were assessed at 0, 1, 6 and 12 months. In addition, we recorded the frequencies of cure, improvement and failure of treatment.
  
  
  RESULTS
  The two groups did not differ with regard to baseline characteristics. In the FMD group, average blood pressure fell from 172/97 to 155/90 mmHg (P < 0.001) at 12 months of follow-up, without significant changes in medication (P = 0.61). Blood pressure in the group without FMD decreased from 168/96 to 150/89 mmHg (P < 0.001), but with an increase in medication (P = 0.03). In the FMD group, 5% of the patients were cured and 43% improved at 12 months. In the other group, these figures were 2 and 24%, respectively. Creatinine clearance did not significantly change after 12 months. Complications of angiography were seen in nine patients of which seven were from the FMD group.
  
  
  CONCLUSIONS
  PTRA resulted in better blood pressure control in patients with FMD as compared to a group without FMD under intensified treatment. Although there was little cure, FMD patients needed less antihypertensive medication. Renal function after PTRA remained stable. The benefits of PTRA should be weighed against a higher risk of complications.
authors.affiliation: Department of Medicine, Maastricht University Medical Centre and Cardiovascular Research Institute Maastricht, Maastricht.
authors.forename: Jasper V
authors.initials: JV
authors.lastname: Smit
authors.forename: Thomas K A
authors.initials: TK
authors.lastname: Wierema
authors.forename: Abraham A
authors.initials: AA
authors.lastname: Kroon
authors.forename: Peter W
authors.initials: PW
authors.lastname: de Leeuw
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017130:Angioplasty; D001794:Blood Pressure; D005260:Female; D005352:Fibromuscular Dysplasia / Q000150:complications / Q000628:therapy*; D005500:Follow-Up Studies; D006801:Humans; D006973:Hypertension / Q000209:etiology / Q000628:therapy*; D007674:Kidney Diseases / Q000503:physiopathology / Q000628:therapy*; D007677:Kidney Function Tests; D008297:Male; D008875:Middle Aged; D016896:Treatment Outcome