Increased C-reactive protein level after renal stent implantation in patients with atherosclerotic renal stenosis.

Abstract

Elevated C-reactive protein (CRP) level has been demonstrated in patients with coronary artery disease after coronary stent implantation, but no data are available in patients with atherosclerotic renal artery stenosis concerning whether such changes of CRP also exist after renal artery stent implantation. The authors hypothesize that elevated CRP level may also be present in patients with atherosclerotic renal artery stenosis after stent implantation owing to mechanical disruption of atherosclerotic plaque. In total, 24 patients were enrolled in this study. Of these, 14 patients with atherosclerotic renal artery stenosis received renal angioplasty plus stent implantation (group A, mean age 51 +/- 8 years), and 14 age- and gender-matched patients underwent renal angiography for diagnostic purpose as a control group (group B, mean age 50 +/- 8 years). Peripheral blood samples were taken before the procedure and at 6 and 24 hours after the procedure in both groups. Plasma CRP concentration was measured by using immunoturbidimetry. The results showed that there was no difference in clinical characteristics or in baseline CRP levels between the 2 groups. However, median CRP level was found to increase significantly at 6 hours from 0.13 to 0.17 mg/dL (p < 0.05), and peaked at 24 hours (0.21 mg/dL) after renal artery stent implantation (p < 0.001). Mean CRP rose from 0.30 +/- 0.09 to 0.37 +/- 0.15 mg/dL at 6 hours (p < 0.05) and peaked at 24 hours (0.43 +/- 0.18 mg/dL) after renal artery stent implantation (p < 0.01), while no such changes were observed after renal angiography in group B (p > 0.05, respectively, at different time points). The results of the present study indicate, from evidence of increased plasma CRP concentrations, that renal artery stent implantation could trigger an inflammatory response due to mechanical disruption of atherosclerotic plaque of the renal artery, which is a pattern very similar to that of coronary stent implantation.