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

✍ Scribed by Leertouwer, Trude C.; Derkx, Frans H.M.; Pattynama, Peter M.T.; Deinum, Jaap; Van Dijk, Lukas C.; Schalekamp, Maarten A.D.H.

• Publisher: Nature Publishing Group
• Year: 2002
• Tongue: English
• Weight: 70 KB
• Volume: 62
• Category: Article
• ISSN: 0085-2538
• DOI: 10.1046/j.1523-1755.2002.00456.x

✦ Synopsis

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.