Effects of renal artery stenting on renal function and blood pressure in patients with atherosclerotic renovascular disease.

OBJECTIVE: To study the effects of percutaneous renal artery intervention on renal function and blood pressure in patients with renal artery stenosis. METHODS: Eighty-seven patients with severe uni- or bi-lateral renal artery stenosis (luminal diameter narrowing >/= 70%) and clinical hypertension received renal artery stenting between January 2002 and December 2002. The changes in blood pressure and serum creatinine level and creatinine clearance (CCr) 48 hours after intervention and during 6 months of follow-up were assessed. RESULTS: Renal stenting was performed in 98 stenotic arteries of 87 patients, and the procedural success rate was 100%. Serum creatinine level was slightly elevated from (176 +/- 21) micro mol/L to (179 +/- 11) micro mol/L (P = 0.15) 48 hours after the procedure, but significantly decreased to (149 +/- 15) micro mol/L at 6 months (P < 0.001). CCr was also greatly improved [(37 +/- 11) ml/min before versus (51 +/- 8) ml/min at 6 months, P < 0.001]. During follow-up, 61% of the patients experienced a normal renal function. Despite conventional medical treatment, systolic and diastolic blood pressures were also significantly decreased after stenting [(163 +/- 23)/(96 +/- 13) mm Hg before versus (148 +/- 12)/(79 +/- 15) mm Hg at 6 months, all P < 0.001], and hypertension was well controlled in 67% of the patients at 6 months' follow-up. CONCLUSION: Renal artery stenting has a high success rate and is effective in improving renal function and blood pressure for patients with severe renal artery stenosis.