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Stent Placement in Patients With Atherosclerotic Renal Artery Stenosis and Impaired Renal Function

2010; American College of Physicians; Volume: 152; Issue: 3 Linguagem: Inglês

10.7326/0003-4819-152-3-201002020-00023

1539-3704

L. Bax,

Vascular anomalies and interventions

Letters2 February 2010Stent Placement in Patients With Atherosclerotic Renal Artery Stenosis and Impaired Renal FunctionLiesbeth Bax, MD, PhD, Willem P.T.M. Mali, MD, PhD, and Jaap J. Beutler, MD, PhDLiesbeth Bax, MD, PhDFrom University Medical Center Utrecht, 3584 CX Utrecht, the Netherlands; and Jeroen Bosch Hospital, 5211 NL ‘s Hertogenbosch, the Netherlands.Search for more papers by this author, Willem P.T.M. Mali, MD, PhDFrom University Medical Center Utrecht, 3584 CX Utrecht, the Netherlands; and Jeroen Bosch Hospital, 5211 NL ‘s Hertogenbosch, the Netherlands.Search for more papers by this author, and Jaap J. Beutler, MD, PhDFrom University Medical Center Utrecht, 3584 CX Utrecht, the Netherlands; and Jeroen Bosch Hospital, 5211 NL ‘s Hertogenbosch, the Netherlands.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-152-3-201002020-00023 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail IN RESPONSE:Our study showed that stent placement incurs costs and complications for an at best uncertain benefit in patients with impaired renal function and atherosclerotic renal artery stenosis (ARAS). For these patients, stenting remains a subject of research. We want to emphasize that we focused our study on impaired renal function and ARAS and therefore do not make statements about other categories of patients, such as those with renovascular hypertension, therapy-refractory hypertension, or congestive heart failure.As discussed in our article, the lower-than-anticipated event rate reduced the power of our study, and we might therefore be dealing with a ...References1. Wheatley K, Ives N, Gray R, Kalra PA, Moss JG, Baigent C, et al; ASTRAL Investigators. Revascularization versus medical therapy for renal-artery stenosis. N Engl J Med. 2009;361:1953-62. [PMID: 19907042] CrossrefMedlineGoogle Scholar2. Farmer CK, Cook GJ, Blake GM, Reidy J, Scoble JE. Individual kidney function in atherosclerotic nephropathy is not related to the presence of renal artery stenosis. Nephrol Dial Transplant. 1999;14:2880-4. [PMID: 10570091] CrossrefMedlineGoogle Scholar3. Suresh M, Laboi P, Mamtora H, Kalra PA. Relationship of renal dysfunction to proximal arterial disease severity in atherosclerotic renovascular disease. Nephrol Dial Transplant. 2000;15:631-6. [PMID: 10809803] CrossrefMedlineGoogle Scholar4. Cheung CM, Wright JR, Shurrab AE, Mamtora H, Foley RN, O'Donoghue DJ, et al. Epidemiology of renal dysfunction and patient outcome in atherosclerotic renal artery occlusion. J Am Soc Nephrol. 2002;13:149-57. [PMID: 11752032] CrossrefMedlineGoogle Scholar5. Wright JR, Shurrab AE, Cheung C, Waldek S, O'Donoghue DJ, Foley RN, et al. A prospective study of the determinants of renal functional outcome and mortality in atherosclerotic renovascular disease. Am J Kidney Dis. 2002;39:1153-61. [PMID: 12046025] CrossrefMedlineGoogle Scholar6. Leertouwer TC, Gussenhoven EJ, Bosch JL, van Jaarsveld BC, van Dijk LC, Deinum J, et al. Stent placement for renal arterial stenosis: where do we stand? A meta-analysis. Radiology. 2000;216:78-85. [PMID: 10887230] CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: From University Medical Center Utrecht, 3584 CX Utrecht, the Netherlands; and Jeroen Bosch Hospital, 5211 NL ‘s Hertogenbosch, the Netherlands.Disclosures: None disclosed. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoStent Placement in Patients With Atherosclerotic Renal Artery Stenosis and Impaired Renal Function Liesbeth Bax , Arend-Jan J. Woittiez , Hans J. Kouwenberg , Willem P.T.M. Mali , Erik Buskens , Frederik J.A. Beek , Branko Braam , Frans T.M. Huysmans , Leo J. Schultze Kool , Matthieu J.C.M. Rutten , Cornelius J. Doorenbos , Johannes C.N.M. Aarts , Ton J. Rabelink , Pierre-François Plouin , Alain Raynaud , Gert A. van Montfrans , Jim A. Reekers , Anton H. van den Meiracker , Peter M.T. Pattynama , Peter J.G. van de Ven , Dammis Vroegindeweij , Abraham A. Kroon , Michiel W. de Haan , Cornelis T. Postma , and Jaap J. Beutler Stent Placement in Patients With Atherosclerotic Renal Artery Stenosis and Impaired Renal Function Samuel J. Mann and Thomas A. Sos Stent Placement in Patients With Atherosclerotic Renal Artery Stenosis and Impaired Renal Function Ion S. Jovin and On Topaz Metrics 2 February 2010Volume 152, Issue 3Page: 198KeywordsHypertensionKidneysPatientsRenal analysisRenal arteriesRenal diseasesRenal failureRevascularizationStenosisStent implantation ePublished: 2 February 2010 Issue Published: 2 February 2010 CopyrightCopyright © 2010 by American College of Physicians. All Rights Reserved.PDF DownloadLoading ...