Abstract 3230: Impact of Baseline Renal Function on Outcomes of Renal Artery Stenting in Hypertensive Patients
BACKGROUND: Stents deployed for renal artery stenosis aim to improve blood pressure (BP) control and preserve renal function. Yet appropriate patient selection and clinical predictors of success remain undefined.
METHODS: We analyzed 67 consecutive patients who received stenting for obstructive renal artery disease (>70% stenosis) between 2002 and 2005. Post-discharge follow up was available for 60 patients (90%). We examined renal function, blood pressure and medications at 6 and 12 months.
RESULTS: All 60 patients were hypertensive, 31% diabetic, 67% dyslipidemic, 65% with coronary artery disease, and 47% had peripheral artery disease. Patients were predominantly Caucasian (95%), male (63%), with mean age 71 ± 9 years, and had baseline BP of 156 ± 23/76 ± 12 mm Hg while receiving 3.3 ± 1.1 antihypertensive medications. Baseline serum creatinine (1.9±1.0 mg/dL) was converted to estimated glomerular filtration rate (eGFR) (44±21 mL/min/1.73m2) by the abbreviated MDRD equation. We observed improvement of eGFR from baseline as well as reduction of systolic BP without change in number of or defined daily doses of medications. Patients with baseline renal dysfunction had significant improvements in systolic BP and eGFR, while those with preserved function did not. (Table⇓)
CONCLUSIONS: Patients with obstructive renal artery stenosis achieved improved BP and renal function with stent placement, yet this benefit was observed primarily in patients with baseline impaired renal function. To promote effective application of this procedure, prospective studies are need to determine which patient groups are likely to derive benefit from renal artery stenting.