Can the pre-dialysis period in stage IV chronic kidney disease be prolonged?

Abstract

Analysed herein are the results of treating a total of 29 patients presenting with stage IV chronic kidney disease (CKD) induced by ischaemic nephropathy. All patients had renal artery stenosis more than 80%, decreased glomerular filtration rate (GFR) below 30 ml/min/1.73m2 and were regarded by the nephrologists as potential candidates for programmed haemodialysis. After preparation aimed at preventing contrast-induced nephropathy all patients underwent stenting of the stenosed renal arteries. In the early postoperative period, 21 patients were found to have stabilization of the GFR with a tendency to increase. One woman developed acute renal failure requiring renal replacement therapy by means of haemodialysis. During the follow-up period from 1 to 5 years, 26 patients showed no progression of azotemia. CKD changed to stage III in 15 patients (p<0.005). Twenty-three (84%) patients during the follow-up period developed no new cardiovascular events. Hence, performing renal revascularization for renal artery stenosis >80% revealed in patients with stage IV CKD promotes prolongation of the dialysis-free period.