MO400: Treatment of Renal Artery Stenosis: Nephrology, the Best Surgery

Abstract

Abstract BACKGROUND AND AIMS Renal artery stenosis causes hypertension in 10–40% of severe cases or refractory to treatment. As a gold standard test for its diagnosis, we have arteriography, which allows the interventional therapeutic option, through angioplasty and/or stenting. There is no consensus on which patient profile would be the optimal candidate for each treatment. We tried to reach an answer by studying a cohort of 25 patients from our centre with a diagnosis of renal artery stenosis in the last 5 years. The objective was to assess the efficacy of isolated or interventional medical treatment with respect to renal function and the number of antihypertensive drugs. METHOD A retrospective observational cohort study was conducted. The study population was the patients who underwent renal arteriography in the last 5 years in our center (n = 25). We define significant stenosis as greater than 60%, bilateral involvement or of other main arteries. We compared the evolution of glomerular filtration in stages (KDIGO), proteinuria (albumin/creatinine ratio in urine) and number of antihypertensive drugs before and 6 months after the therapy used. RESULTS Renal arteriography was diagnostic in 18 patients: 13 of them presented significant stenosis, performing angioplasty in 4, stenting in 6 and angioplasty + stenting in 3. One antihypertensive drug was reduced in 17% of the patients, two in 22%, and one drug was increased in one of them. In 83% of the patients, the KDIGO stage of renal function did not change after treatment. An improvement was observed in three patients, who only received medical treatment. No differences were found in the evolution of proteinuria. CONCLUSION There were no statistically significant differences in renal function and the number of antihypertensive drugs between isolated medical versus medical and interventional treatment. It is necessary to expand the patient database, or start multicenter studies, to improve the significance.