Split renal function in patients with unilateral atherosclerotic renal artery stenosis—effect of renal angioplasty

ObjectiveTo evaluate the effect of percutaneous transluminal renal angioplasty (PTRA) on split renal function (SRF) in patients with unilateral atherosclerotic renal artery stenosis (ARAS).MethodsWe performed a retrospective analysis of all consecutively examined patients at our centre with signific...

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Bibliographic Details
Published in:Clinical kidney journal 2017-08, Vol.10 (4), p.496-502
Main Authors: Saeed, Aso, Fortuna, Elzbieta Nowakowska, Jensen, Gert
Format: Article
Language:English
Subjects:
colour duplex sonography
disease
endothelin-1
medical therapy
renal angiography
renal artery stenosis
renovascular hypertension
revascularization
split
Urologi och njurmedicin
Urology & Nephrology
Urology and Nephrology
Vascular Disease
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Summary:ObjectiveTo evaluate the effect of percutaneous transluminal renal angioplasty (PTRA) on split renal function (SRF) in patients with unilateral atherosclerotic renal artery stenosis (ARAS).MethodsWe performed a retrospective analysis of all consecutively examined patients at our centre with significant ARAS undergoing PTRA during 2002–07. A significant ARAS was defined as a lesion with a trans-stenotic mean arterial pressure gradient of at least 10 mmHg or a diameter stenosis >50% on angiography. Ambulatory (24 h) systolic and diastolic blood pressure (ASBP and ADBP, respectively) and calculated SRF using 99mTc-DTPA renal scintigraphy were evaluated before (baseline) and 4 weeks after PTRA.ResultsASBP and ADBP were significantly lower 4 weeks after PTRA compared with baseline levels. Although total estimated glomerular filtration rate (eGFR; four-variable Modification of Diet in Renal Disease equation) had not changed by PTRA, analysis of SRF showed significantly increased eGFR in stenotic kidneys and a comparable reduction in eGFR in non-stenotic kidneys 4 weeks after PTRA.ConclusionsIn patients with unilateral ARAS, PTRA significantly improved eGFR in stenotic kidneys and decreased filtration in contralateral, non-stenotic kidneys. These potentially beneficial effects may not be apparent when total renal function remains stable. The clinical significance of these findings needs to be evaluated further.
ISSN:2048-8505
1753-0784
1753-0792
2048-8513
DOI:10.1093/ckj/sfx052