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NDT Advance Access originally published online on March 29, 2007
Nephrology Dialysis Transplantation 2007 22(7):1916-1919; doi:10.1093/ndt/gfm130
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© The Author [2007]. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org

Efficacy of renal artery angioplasty and stenting in a solitary functioning kidney

Jackson Tan1, Rafik Filobbos1, Girish Raghunathan2, Tony Nicholson1, Richard Fowler1, Mark Wright1 and David Eadington3

1Leeds General Infirmary, Great George Street, Leeds LS1 3EX, 2St. James Hospital, Beckett Street, Leeds LS9 7TF and 3Hull Royal Infirmary, Anlaby Road, Hull HU3 2JZ, UK

Correspondence and offprint requests to: Dr Jackson Tan, Leeds General Infirmary, Great George Street, Leeds LS1 3EX, UK. Email: jcstan1810{at}yahoo.co.uk



  Abstract

Objective. The aim of this study was to share our experience of percutaneous renal artery angioplasty and stenting (PTRAS) in our patients with a solitary functioning kidney over a 10-year period.

Methods. The procedures were performed on 75 patients from 1995 to 2004. Data were collected retrospectively from case notes of patients. The definition for solitary functioning kidney was a contralateral kidney size of <8 cm, complete occlusion of contralateral renal artery or previous nephrectomy. Serum creatinine was considered improved or worse if the deviation from the baseline value was >20%.

Results. For the purpose of halting renal deterioration (n = 47), there were improvement and stabilization in 21% and 55% at 3 months and 28% and 28% at 12 months. Systolic blood pressure (n = 27) improvement and stabilization were achieved in 33% and 56% both at 3 and 12 months. Diastolic blood pressure (n = 27) improvement and stabilization were 22% and 70% at 3 months and 33% and 48% at 12 months. Five out of seven patients with acute renal failure (serum creatinine >500 µmol/l and requiring haemodialysis) pre-procedure were dialysis-free at 12 months. Complications occurred in 19 (25%) patients and these included bleeding (n = 16), pseudoaneurysm (n = 3), renal artery dissection (n = 2) and cholesterol embolization (n = 1).

Conclusion. PTRAS in a solitary functioning kidney produced clinical benefits in the majority of patients with resistant hypertension and renal function deterioration.

Keywords: acute renal failure; angioplasty; hypertension; renal artery stenosis; single; solitary; stenting

Received for publication: 3. 7.06
Accepted in revised form: 14. 2.07


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