Attenuation of Renal Functional Decline Following Angioplasty and Stenting in Atherosclerotic Renovascular Disease

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dc.contributor.authorHagemann, Rodrigo [UNESP]
dc.contributor.authorDos Santos Silva, Vanessa [UNESP]
dc.contributor.authorCardoso Carvalho, Fábio [UNESP]
dc.contributor.authorBarretti, Pasqual [UNESP]
dc.contributor.authorMartin, Luis Cuadrado [UNESP]
dc.contributor.authorVassallo, Diana [UNESP]
dc.contributor.authorKalra, Philip A. [UNESP]
dc.contributor.authorDa Silva Franco, Roberto Jorge [UNESP]
dc.contributor.institutionUniversidade Estadual Paulista (Unesp)
dc.date.accessioned2018-12-11T17:07:21Z
dc.date.available2018-12-11T17:07:21Z
dc.date.issued2017-01-01
dc.description.abstractBackground: To date, renal revascularization has not been shown to be advantageous when compared to optimized medical treatment in patients with atheromatous renovascular disease (ARVD). This study aims to investigate the effect of revascularization in patients with pre-intervention worsening renal function and in those with stable renal function. Patients and Methods: In this single-centre observational study, patients who were diagnosed with at least 60% angiographic stenosis unilaterally or bilaterally between January 1996 and October 2008 and who were followed-up until February 2011 were retrospectively analysed. Evolution of renal function was determined from the slope of reciprocal of serum creatinine (RCr-slope) before and after diagnostic angiography or revascularization; this required 5 or more creatinine measurements before and at least another 5 measurements post-procedure. Patients were divided into 2 groups: one comprising patients with negative RCr-slope before the procedure and a second group of patients with prior positive RCr-slope. A stepwise, adjusted logistic regression was used to determine the OR of revascularization on attenuation of RCr-slope. Results: Data for 52 patients were analysed. Median age was 64 (58-72) and median follow-up was 15 (8-34) months. Only patients with a negative RCr-slope (-0.0078 (95% CI -0.0174, -0.0033) dl/mg/month) who underwent revascularization manifested an improved RCr-slope during follow-up (+0.0013 (95% CI -0.0002, 0.0039) dl/mg/month, p < 0.001). This finding remained statistically significant even after the adjustment for proteinuria and bilateral arterial disease. Conclusion: Revascularization may be indicated for patients with ARVD and progressively worsening renal function. This patient subgroup should ideally be evaluated in future randomized controlled trials.en
dc.description.affiliationDisciplina de Nefrologia Departamento de Clínica Médica Faculdade de Medicina de Botucatu Universidade Estadual Paulista (UNESP)
dc.description.affiliationUnespDisciplina de Nefrologia Departamento de Clínica Médica Faculdade de Medicina de Botucatu Universidade Estadual Paulista (UNESP)
dc.format.extent15-22
dc.identifierhttp://dx.doi.org/10.1159/000447753
dc.identifier.citationNephron, v. 135, n. 1, p. 15-22, 2017.
dc.identifier.doi10.1159/000447753
dc.identifier.issn2235-3186
dc.identifier.issn1660-8151
dc.identifier.lattes5496411983893479
dc.identifier.lattes4923203168446615
dc.identifier.orcid0000-0003-4979-4836
dc.identifier.scopus2-s2.0-84992743742
dc.identifier.urihttp://hdl.handle.net/11449/173702
dc.language.isoeng
dc.relation.ispartofNephron
dc.rights.accessRightsAcesso aberto
dc.sourceScopus
dc.subjectAtherosclerotic renovascular disease
dc.subjectChronic kidney disease progression
dc.subjectEnd-stage kidney disease
dc.subjectRevascularization
dc.titleAttenuation of Renal Functional Decline Following Angioplasty and Stenting in Atherosclerotic Renovascular Diseaseen
dc.typeArtigo
unesp.author.lattes5496411983893479[4]
unesp.author.lattes4923203168446615
unesp.author.orcid0000-0003-4979-4836[4]

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