Renovascular Hypertension: Renal Artery Stenting Slows the Rate of Renal Function Decline

Zachary Arthurs, MD, Daniel Cuadrado, MD, Benjamin Starnes, MD and Charles Andersen, MD
Madigan Army Medical Center, Department of Vascular and Endovascular Surgery,Tacoma, WA

Objective: The primary objective of this study was to analyze outcomes of Renal Artery Intervention performed at a tertiary medical center.
Methods: This study is a retrospective analysis of patients treated at a tertiary medical center from January 2001 - December 2005. All patients treated with renal artery stenting by the Interventional Radiology or Vascular Surgery Service were included. Descriptive and inferential analysis was performed using SPSS version 10.0.5 statistical software package.
Results: 30 renal artery stents were placed in 23 patients. Mean age was 70(±8) years. 77% were treated for multi-drug resistant hypertension; 23% were treated for renal salvage. Mean follow-up was 15 months. Patients experienced a significant reduction in hypertension and number of anti-hypertensive agents, but this significance deteriorated at 6 months follow-up when their blood pressure and number of medications returned to pre-procedural values. The rate of renal function decline improved from 0.07mg/dl/month to 0.03mg/dl/month (p<0.05) after intervention compared to a cohort that were followed with medical management alone.

Conclusions: Renal artery stenting initially improves hypertension control, but after 6 months, the durability of intervention declines. Renal artery stenting dramatically slows the rate of renal function decline, and could potentially delay a patient's presentation to chronic hemodialysis.