Effect of renal-artery stenting on progression of renovascular renal failure

P.N. Harden, M.J. MacLeod, R.S.C. Rodger, G.M. Baxter, J.M.C. Connell, A.F. Dominiczak, B.J.R. Junor, J.D. Briggs, J.G. Moss

Research output: Contribution to journalArticle

386 Citations (Scopus)

Abstract

Background Placement of renal-artery stents has a high technical success rate in atherosclerotic renovascular disease, but little is known about the clinical benefits of the procedure. We monitored renal function serially before and after stent insertion in patients with renovascular renal failure. Methods Renal function was assessed before and after stent placement by means of serial serum creatinine values in 32 patients with atherosclerotic renal-artery stenosis. The effect on the progression of renal failure was analysed in 23 patients by comparison of the reciprocal slopes of serum creatinine versus time plots before and after stent placement. Findings 33 transluminal stents were placed in 32 patients with atherosclerotic renovascular disease. Immediate patency was achieved in all cases; the angiographic restenosis rate at 6 months was 12% (n=24). One patient died after a procedure-related haemorrhage. Median diastolic blood pressure was significantly lower after stenting than before (95 [IQR 86–103] vs 87 [81–90] mm Hg; p>0·01) but the requirement for antihypertensive drugs was unchanged. Renal function improved or stabilised in 22 (69%) of the 32 patients. Progression of renal failure was significantly slowed after the procedure; the mean (SE) of the slopes of reciprocal serum creatinine values was −4·34 (0·85) L μmol−1 day−1 before stent placement, and −0·55 (1·0) L μmol−1 day−1 after stent placement (p< 0·01, two-sample t test). Interpretation Renal-stent placement in selected patients slows the progression of renovascular renal failure and may delay the need for renal replacement therapy.
Original languageEnglish
Pages (from-to)1133-1136
Number of pages4
JournalLancet
Volume349
Issue number9059
DOIs
Publication statusPublished - 19 Apr 1997

Fingerprint

Renal Artery
Stents
Renal Insufficiency
Creatinine
Serum
Blood Pressure
Kidney
Renal Artery Obstruction
Renal Replacement Therapy
Cerebral Palsy
Antihypertensive Agents
Hemorrhage

Cite this

Harden, P. N., MacLeod, M. J., Rodger, R. S. C., Baxter, G. M., Connell, J. M. C., Dominiczak, A. F., ... Moss, J. G. (1997). Effect of renal-artery stenting on progression of renovascular renal failure. Lancet, 349(9059), 1133-1136. https://doi.org/10.1016/S0140-6736(96)10093-3

Effect of renal-artery stenting on progression of renovascular renal failure. / Harden, P.N.; MacLeod, M.J.; Rodger, R.S.C.; Baxter, G.M.; Connell, J.M.C.; Dominiczak, A.F.; Junor, B.J.R.; Briggs, J.D.; Moss, J.G.

In: Lancet, Vol. 349, No. 9059, 19.04.1997, p. 1133-1136.

Research output: Contribution to journalArticle

Harden, PN, MacLeod, MJ, Rodger, RSC, Baxter, GM, Connell, JMC, Dominiczak, AF, Junor, BJR, Briggs, JD & Moss, JG 1997, 'Effect of renal-artery stenting on progression of renovascular renal failure', Lancet, vol. 349, no. 9059, pp. 1133-1136. https://doi.org/10.1016/S0140-6736(96)10093-3
Harden PN, MacLeod MJ, Rodger RSC, Baxter GM, Connell JMC, Dominiczak AF et al. Effect of renal-artery stenting on progression of renovascular renal failure. Lancet. 1997 Apr 19;349(9059):1133-1136. https://doi.org/10.1016/S0140-6736(96)10093-3
Harden, P.N. ; MacLeod, M.J. ; Rodger, R.S.C. ; Baxter, G.M. ; Connell, J.M.C. ; Dominiczak, A.F. ; Junor, B.J.R. ; Briggs, J.D. ; Moss, J.G. / Effect of renal-artery stenting on progression of renovascular renal failure. In: Lancet. 1997 ; Vol. 349, No. 9059. pp. 1133-1136.
@article{076cf45e11784a1fababdc181d8bb2d2,
title = "Effect of renal-artery stenting on progression of renovascular renal failure",
abstract = "Background Placement of renal-artery stents has a high technical success rate in atherosclerotic renovascular disease, but little is known about the clinical benefits of the procedure. We monitored renal function serially before and after stent insertion in patients with renovascular renal failure. Methods Renal function was assessed before and after stent placement by means of serial serum creatinine values in 32 patients with atherosclerotic renal-artery stenosis. The effect on the progression of renal failure was analysed in 23 patients by comparison of the reciprocal slopes of serum creatinine versus time plots before and after stent placement. Findings 33 transluminal stents were placed in 32 patients with atherosclerotic renovascular disease. Immediate patency was achieved in all cases; the angiographic restenosis rate at 6 months was 12{\%} (n=24). One patient died after a procedure-related haemorrhage. Median diastolic blood pressure was significantly lower after stenting than before (95 [IQR 86–103] vs 87 [81–90] mm Hg; p>0·01) but the requirement for antihypertensive drugs was unchanged. Renal function improved or stabilised in 22 (69{\%}) of the 32 patients. Progression of renal failure was significantly slowed after the procedure; the mean (SE) of the slopes of reciprocal serum creatinine values was −4·34 (0·85) L μmol−1 day−1 before stent placement, and −0·55 (1·0) L μmol−1 day−1 after stent placement (p< 0·01, two-sample t test). Interpretation Renal-stent placement in selected patients slows the progression of renovascular renal failure and may delay the need for renal replacement therapy.",
author = "P.N. Harden and M.J. MacLeod and R.S.C. Rodger and G.M. Baxter and J.M.C. Connell and A.F. Dominiczak and B.J.R. Junor and J.D. Briggs and J.G. Moss",
year = "1997",
month = "4",
day = "19",
doi = "10.1016/S0140-6736(96)10093-3",
language = "English",
volume = "349",
pages = "1133--1136",
journal = "The Lancet",
issn = "0140-6736",
publisher = "ACADEMIC PRESS INC ELSEVIER SCIENCE",
number = "9059",

}

TY - JOUR

T1 - Effect of renal-artery stenting on progression of renovascular renal failure

AU - Harden, P.N.

AU - MacLeod, M.J.

AU - Rodger, R.S.C.

AU - Baxter, G.M.

AU - Connell, J.M.C.

AU - Dominiczak, A.F.

AU - Junor, B.J.R.

AU - Briggs, J.D.

AU - Moss, J.G.

PY - 1997/4/19

Y1 - 1997/4/19

N2 - Background Placement of renal-artery stents has a high technical success rate in atherosclerotic renovascular disease, but little is known about the clinical benefits of the procedure. We monitored renal function serially before and after stent insertion in patients with renovascular renal failure. Methods Renal function was assessed before and after stent placement by means of serial serum creatinine values in 32 patients with atherosclerotic renal-artery stenosis. The effect on the progression of renal failure was analysed in 23 patients by comparison of the reciprocal slopes of serum creatinine versus time plots before and after stent placement. Findings 33 transluminal stents were placed in 32 patients with atherosclerotic renovascular disease. Immediate patency was achieved in all cases; the angiographic restenosis rate at 6 months was 12% (n=24). One patient died after a procedure-related haemorrhage. Median diastolic blood pressure was significantly lower after stenting than before (95 [IQR 86–103] vs 87 [81–90] mm Hg; p>0·01) but the requirement for antihypertensive drugs was unchanged. Renal function improved or stabilised in 22 (69%) of the 32 patients. Progression of renal failure was significantly slowed after the procedure; the mean (SE) of the slopes of reciprocal serum creatinine values was −4·34 (0·85) L μmol−1 day−1 before stent placement, and −0·55 (1·0) L μmol−1 day−1 after stent placement (p< 0·01, two-sample t test). Interpretation Renal-stent placement in selected patients slows the progression of renovascular renal failure and may delay the need for renal replacement therapy.

AB - Background Placement of renal-artery stents has a high technical success rate in atherosclerotic renovascular disease, but little is known about the clinical benefits of the procedure. We monitored renal function serially before and after stent insertion in patients with renovascular renal failure. Methods Renal function was assessed before and after stent placement by means of serial serum creatinine values in 32 patients with atherosclerotic renal-artery stenosis. The effect on the progression of renal failure was analysed in 23 patients by comparison of the reciprocal slopes of serum creatinine versus time plots before and after stent placement. Findings 33 transluminal stents were placed in 32 patients with atherosclerotic renovascular disease. Immediate patency was achieved in all cases; the angiographic restenosis rate at 6 months was 12% (n=24). One patient died after a procedure-related haemorrhage. Median diastolic blood pressure was significantly lower after stenting than before (95 [IQR 86–103] vs 87 [81–90] mm Hg; p>0·01) but the requirement for antihypertensive drugs was unchanged. Renal function improved or stabilised in 22 (69%) of the 32 patients. Progression of renal failure was significantly slowed after the procedure; the mean (SE) of the slopes of reciprocal serum creatinine values was −4·34 (0·85) L μmol−1 day−1 before stent placement, and −0·55 (1·0) L μmol−1 day−1 after stent placement (p< 0·01, two-sample t test). Interpretation Renal-stent placement in selected patients slows the progression of renovascular renal failure and may delay the need for renal replacement therapy.

UR - http://www.scopus.com/inward/record.url?eid=2-s2.0-0030929576&partnerID=MN8TOARS

U2 - 10.1016/S0140-6736(96)10093-3

DO - 10.1016/S0140-6736(96)10093-3

M3 - Article

VL - 349

SP - 1133

EP - 1136

JO - The Lancet

JF - The Lancet

SN - 0140-6736

IS - 9059

ER -