Journal Article

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

Niina Koivuviita, Kaisa Liukko, Nobu Kudomi, Vesa Oikonen, Risto Tertti, Ilkka Manner, Tero Vahlberg, Pirjo Nuutila and Kaj Metsärinne

in Nephrology Dialysis Transplantation

Published on behalf of European Renal Association - European Dialysis and Transplant Assoc

Volume 27, issue 10, pages 3843-3848
Published in print October 2012 | ISSN: 0931-0509
Published online July 2012 | e-ISSN: 1460-2385 | DOI: http://dx.doi.org/10.1093/ndt/gfs301
The effect of revascularization of renal artery stenosis on renal perfusion in patients with atherosclerotic renovascular disease

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Background

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.

Results

Although 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.

Keywords: atherosclerotic renovascular disease; imaging; renal artery stenosis; revascularization

Journal Article.  3560 words.  Illustrated.

Subjects: Nephrology

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