The effect of revascularization of renal artery stenosis on renal perfusion in patients with atherosclerotic renovascular disease

1Department of Medicine, Turku University Hospital, PL 52, Kiinamyllynkatu 4-8, Turku 20521, Finland.
Nephrology Dialysis Transplantation (Impact Factor: 3.58). 07/2012; 27(10). DOI: 10.1093/ndt/gfs301
Source: PubMed


Only a small fraction of patients with atherosclerotic renovascular disease (ARVD) treated with revascularization have improved renal function after the procedure. It has been suggested that this may be due to effects of renal microvascular disease. Our aim was to measure the effect of renal artery stenosis (RAS) revascularization on renal perfusion in patients with renovascular disease.Methods
Seventeen renovascular disease patients were treated by dilatation of unilateral (N = 8) or bilateral (N = 9) RAS (N = 23 kidneys), mainly because of uncontrolled or refractory hypertension. The patients were studied before and after (103 ± 29 days) the procedure. Renal perfusion was measured using quantitative positron emission tomography (PET) perfusion imaging.ResultsAlthough renal perfusion correlated inversely with the degree of RAS in patients with renovascular disease, it did not change after revascularization.Conclusions
Our data support the notion of former clinical trials that angiographic severity of RAS does not determine the response to revascularization. Quantitative PET perfusion imaging is a promising tool to noninvasively measure renal perfusion for the assessment of physiological impact of RAS.

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Available from: Niina Susanna Koivuviita
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    • "Moreover, some studies reported that stent implantation in patients with renal artery stenosis showed no beneficial effect on development of AKI after cardiac surgery. [42], [43] Since those kidneys typically exhibit nephron loss, nephrosclerosis, small vessel arteriosclerosis, and atheroembolic disease, lesions was not usually be reversible even with successful revascularization [44], [45]. "
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