Renal Outcome Following Stenting for Renal Artery Stenosis

Korean Journal of Nephrology 2008;27(4):439-445.

Jae Hyun Chang, M.D.1, 2, Hyun-Wook Kim, M.D.1, 2, Sun Young Park, M.D.1, 2, Dong Ki Kim, M.D.1, 2, Sung Jin Moon, M.D.1, 2, Donghoon Choi, M.D.1, Won-Heum Shim, M.D.1, Beom Seok Kim, M.D.1, 2, Shin-Wook Kang, M.D.1, 2, Ho Yung Lee, M.D.1, 2, Dae Suk Han,

Department of Internal Medicine¹
The Institute of Kidney Disease2 Yonsei University College of Medicine, Seoul, Korea

임상연구 : 신동맥 협착 환자에서 스텐트 삽입술 후 신기능의 변화

장제현1, 2, 김현욱1, 2, 박선영1, 2, 김동기1, 2, 문성진1, 2, 최동훈1, 심원흠1, 김범석1, 2, 강신욱1, 2, 이호영1, 2, 한대석1, 2, 최규헌1, 2

연세대학교 의과대학 내과학교실1, 신장질환연구소2

Abstract

Purpose : Renal artery stenosis (RAS) causes or deteriorates hypertension and/or renal insufficiency, and is known as a progressive disease. The aim of this study is to reveal the change of renal function after stenting for RAS. Methods : We retrospectively analyzed 66 patients between 1999 and 2005 who had stenting for RAS. Renal function was assessed by modified MDRD equation. According to baseline glomerular filtration rate (GFR), patients were divided into subgroups with group A (n=37, GFR ≥60 mL/min/1.73m2) or group B (n=29, GFR <60 mL/min/1.73m2). Clinical parameters were compared between two groups. Results : A total of 66 patients (male:female=37:29) were studied. The mean age was 61±12 years old and the mean follow-up duration was 54±27 months. Sixty-one (92.4%) patients had hypertension, 20 (30.3%) had diabetes, and 48 (73%) had unilateral RAS. Group B was older than group A (65±9 vs. 58±14 years old). The mean body mass index of group B was higher than that of group A. In group A, there was a decrease in the MDRD GFR (from 75±11 to 70±15 mL/min/1.73m2; p=0.038). In contrast, in group B there was no significant change in the MDRD GFR (from 48±9 to 48±15 mL/min/1.73m2). In group A and group B, renal function has been improved in 3% and 24%, and stabilized in 70% and 52%, respectively. Conclusion : Stenting for RAS has renal function preserving effect in patients with renal insufficiency. Therefore, stenting should be considered as a treatment modality in RAS patients even with deteriorated renal function.

Key Words: Stenosis, Stent, Glomerular filtration rate, Renal artery