Functional effects of renal artery stent placement on treated and contralateral kidneys.

Abstract:

BACKGROUND:This study examined the effects of stent placement for renal artery stenosis on the function of treated and contralateral kidneys. METHODS:Eighteen patients who underwent stent placement for unilateral renal artery stenosis presenting with hypertension and/or renal failure were studied before angiography and stent placement and at their one-year follow-up. Renal vein blood samples were taken at both sides, at each side simultaneously with a sample from the aorta, to measure the plasma renin concentration and the concentrations of 131I-hippuran and 125I-thalamate during constant systemic infusion of these radiochemicals. This allowed an assessment of the single-kidney contributions to the total renin secretion, effective renal plasma flow (131I-hippuran clearance) and glomerular filtration rate (125I-thalamate clearance). RESULTS:At the one-year follow-up, the vein-to-artery renin ratio at the treated side had decreased to normal, from 1.65 +/- 0.131 to 1.23 +/- 0.076 (mean +/- SEM; P = 0.011), indicating an improved renal blood flow. Contralaterally it rose from 1.09 +/- 0.042 to 1.17 +/- 0.029 (P = 0.055) at follow-up. The extraction ratio of 131I-hippuran improved at the treated side (0.48 +/- 0.049 to 0.62 +/- 0.034; P = 0.003) and contralaterally (0.67 +/- 0.033 to 0.73 +/- 0.026; P = 0.043). The extraction ratio of 125I-thalamate, which equals filtration fraction, improved at both sides (0.12 +/- 0.014 to 0.17 +/- 0.012 at the treated side, P = 0.001; 0.18 +/- 0.013 to 0.22 +/- 0.011 contralaterally, P = 0.002). Two-kidney effective renal blood flow and glomerular filtration rate remained unchanged. CONCLUSION:Renal artery stenting was capable of causing improvement of glomerular filtration rate of the treated kidney, although the overall glomerular filtration rate did not change.

journal_name

Kidney Int

journal_title

Kidney international

authors

Leertouwer TC,Derkx FH,Pattynama PM,Deinum J,van Dijk LC,Schalekamp MA

doi

10.1046/j.1523-1755.2002.00456.x

subject

Has Abstract

pub_date

2002-08-01 00:00:00

pages

574-9

issue

2

eissn

0085-2538

issn

1523-1755

pii

S0085-2538(15)48586-2

journal_volume

62

pub_type

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